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Special Issue "Advances in Interventional Cardiology and Vascular Medicine"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (1 December 2017)

Special Issue Editors

Guest Editor
Dr. Aseem Vashist

Associate Professor of Medicine, University of Connecticut School of Medicine, Hoffman Heart and Vascular Institute, St. Francis Hospital and Medical Center, VACT Healthcare System, Connecticut, USA
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Interests: interventional cardiology and vascular medicine
Guest Editor
Dr. Steven E. Pfau

Director, Cardiac Catheterization Laboratory, VA Connecticut, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
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Special Issue Information

Dear Colleagues,

We are excited to serve as the Guest Editors for a Special Issue of the Journal of Clinical Medicine, dedicated to advances in interventional cardiology and vascular medicine” to be published in January-February 2018. This Special Issue, titled “Advances in Interventional Cardiology and Vascular Medicine” will focus on current advances in coronary and peripheral vascular disease and intervention.

There has been significant progress in the field of interventional cardiology from newer devices to newer applications of technology, resulting in improved cardiovascular outcomes. The goal of this Special Issue would be to update the practicing clinician and provide a comprehensive collection of review articles and editorials.

To this end, we would like to invite state-of-the-art reviews, including reviews of new technology and therapeutics, as well as original research in this area will be considered for inclusion in this issue. Examples include history and evolution of interventional techniques, reviews of specific devices (i.e., stent technology, atherectomy devices, and robotics), medical therapy (i.e., anti-platelet therapy in coronary or peripheral intervention), specific clinical problems (i.e., risk/benefit in revascularization in stable CAD or stable claudication), advances in the management of challenging coronary anatomy and interventional techniques in the management of heart failure, venous insufficiency, peripheral arterial diseases and pulmonary embolism.

We highly encourage submission of manuscripts that would integrate vascular biology and medicine especially as it relates to imaging plaque vulnerability and future directions in vascular imaging.

The deadline for submission of these articles to the journal is 1 December, 2017. We look forward to your submissions!

Dr. Aseem Vashist
Dr. Steven E. Pfau
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (9 papers)

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Review

Open AccessReview Update in Spontaneous Coronary Artery Dissection
J. Clin. Med. 2018, 7(9), 228; https://doi.org/10.3390/jcm7090228
Received: 27 June 2018 / Revised: 20 July 2018 / Accepted: 19 August 2018 / Published: 21 August 2018
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Abstract
There has been increased awareness in the understanding and recognition of spontaneous coronary artery disease. Diagnosing this condition is of paramount importance as the treatment strategy differs greatly from traditional acute coronary syndrome patient. We review here the current state of management of
[...] Read more.
There has been increased awareness in the understanding and recognition of spontaneous coronary artery disease. Diagnosing this condition is of paramount importance as the treatment strategy differs greatly from traditional acute coronary syndrome patient. We review here the current state of management of spontaneous coronary artery disease. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessReview Percutaneous Left Main Coronary Intervention: A Review of Plaque Modification in Left Main Percutaneous Coronary Intervention
J. Clin. Med. 2018, 7(7), 180; https://doi.org/10.3390/jcm7070180
Received: 1 July 2018 / Revised: 19 July 2018 / Accepted: 20 July 2018 / Published: 23 July 2018
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Abstract
Left main coronary artery (LMCA) stenosis has long been recognized as a marker of increased morbidity and mortality. Current treatment algorithms for LMCA stenosis consider both percutaneous coronary intervention (PCI) with drug eluting stents (DES) and coronary bypass surgery, each with advantages based
[...] Read more.
Left main coronary artery (LMCA) stenosis has long been recognized as a marker of increased morbidity and mortality. Current treatment algorithms for LMCA stenosis consider both percutaneous coronary intervention (PCI) with drug eluting stents (DES) and coronary bypass surgery, each with advantages based on individual patient characteristics. Since the LMCA is the largest artery in the coronary tree, plaque volume and calcification is greater than other coronary segments and often extends to the distal bifurcation segment. In LMCA bifurcation lesions, larger minimal stent area is strongly associated with better outcome in the DES era. Plaque modification strategies such as rotational, orbital, or laser atherectomy are effective mechanisms to reduce plaque volume and alter compliance, facilitating stent delivery and stent expansion. We present a case of a calcified, medina class 1,1,1 LMCA lesion where intravascular ultrasound (IVUS) and orbital atherectomy were employed for optimal results. In this context, we review the evidence of plaque modification devices and the rationale for their use in unprotected left main PCI. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessReview Coronary Stents: History, Design, and Construction
J. Clin. Med. 2018, 7(6), 126; https://doi.org/10.3390/jcm7060126
Received: 20 April 2018 / Revised: 17 May 2018 / Accepted: 22 May 2018 / Published: 29 May 2018
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Abstract
The history of percutaneous coronary intervention (PCI) is marked by rapid technological advancements that have taken place over the past 40 years. After a period of balloon angioplasty, which was marred by risk of abrupt vessel closure and vessel recoil, balloon expandable metal
[...] Read more.
The history of percutaneous coronary intervention (PCI) is marked by rapid technological advancements that have taken place over the past 40 years. After a period of balloon angioplasty, which was marred by risk of abrupt vessel closure and vessel recoil, balloon expandable metal alloy stents were the mainstay of PCI. The introduction of drug eluting stents (DES) targeted in-stent restenosis, a common mode of stent failure, and ushered in the current PCI era. Since the first generation of DES, advances in polymer science and stent design have advanced the field. The current generation of DES has thin struts, are highly deliverable, have biocompatible or absorbable polymers, and outstanding safety and efficacy profiles. In this review, we discuss the technological advancements in stent development, design, and construction, with an emphasis on balloon expandable stents. The aspects of stent properties, metal alloys, bioresorbable vascular scaffolds, drug elution, and polymers will be covered. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessReview Review of the Latest Percutaneous Devices in Critical Limb Ischemia
J. Clin. Med. 2018, 7(4), 82; https://doi.org/10.3390/jcm7040082
Received: 30 March 2018 / Revised: 10 April 2018 / Accepted: 10 April 2018 / Published: 14 April 2018
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Abstract
Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death. Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within
[...] Read more.
Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death. Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within the past decade. This review summarizes the types of percutaneous devices and the techniques that are available for the management of CLI and the data supporting their use. These include devices that establish and maintain vessel patency, including percutaneous transluminal angioplasty, drug-coated balloons, bare metal stents, drug-eluting stents, bioresorbable vascular scaffolds, and atherectomy; devices that provide protection from embolization; and, cell-based therapies. Additionally, ongoing trials with important implications for the field are discussed. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
Open AccessFeature PaperReview Latest Innovations in the Treatment of Venous Disease
J. Clin. Med. 2018, 7(4), 77; https://doi.org/10.3390/jcm7040077
Received: 3 March 2018 / Revised: 8 April 2018 / Accepted: 10 April 2018 / Published: 11 April 2018
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Abstract
Venous disease is more common than peripheral arterial disease. Pathophysiologically, venous disease can be associated with obstruction, reflux, or both. A common feature in chronic venous disease is ambulatory venous hypertension. Inflammatory and pro-thrombotic mechanisms can be activated. The current therapies, including compression,
[...] Read more.
Venous disease is more common than peripheral arterial disease. Pathophysiologically, venous disease can be associated with obstruction, reflux, or both. A common feature in chronic venous disease is ambulatory venous hypertension. Inflammatory and pro-thrombotic mechanisms can be activated. The current therapies, including compression, ablation, and recanalization are discussed. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessReview Antiplatelet Therapy in Coronary Artery Disease: A Daunting Dilemma
J. Clin. Med. 2018, 7(4), 74; https://doi.org/10.3390/jcm7040074
Received: 14 March 2018 / Revised: 5 April 2018 / Accepted: 6 April 2018 / Published: 9 April 2018
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Abstract
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been
[...] Read more.
Percutaneous coronary intervention (PCI) with stenting for the treatment of acute coronary syndrome (ACS) is the contemporary standard of care. Such treatment is followed by dual antiplatelet therapy (DAPT) comprising of aspirin and a P2Y12 inhibitor. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention. The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities. Major societal guidelines have emphasized comprehensive assessment of ischemic and bleeding risk, in turn recommending individualization of DAPT duration, thus encouraging “shared decision making”. The following review is aimed at critically evaluating the available evidence to help make these crucial clinical decisions regarding duration of DAPT and triple therapy. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessReview Safety, Efficacy and Evidence Base for Use of the Subcutaneous Implantable Cardioverter Defibrillator
J. Clin. Med. 2018, 7(3), 53; https://doi.org/10.3390/jcm7030053
Received: 28 December 2017 / Revised: 16 February 2018 / Accepted: 6 March 2018 / Published: 11 March 2018
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Abstract
The trans-venous implantable cardioverter defibrillator (TV-ICD) is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. However, there are significant short- and long-term complications that are associated with intravascular leads. These shortcomings are mostly relevant in young patients with long
[...] Read more.
The trans-venous implantable cardioverter defibrillator (TV-ICD) is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. However, there are significant short- and long-term complications that are associated with intravascular leads. These shortcomings are mostly relevant in young patients with long life expectancy and low risk of death from non-arrhythmic causes. Drawbacks of trans-venous leads recently led to the development of the entirely subcutaneous implantable cardioverter defibrillator (S-ICD). The S-ICD does not require vascular access or permanent intravascular defibrillation leads. Therefore, it is expected to overcome many complications associated with conventional ICDs. This review highlights data on safety and efficacy of the S-ICD and is envisioned to help in identifying the role of this device in clinical practice. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessFeature PaperReview Update on the Non-Pharmacological Management of Stroke Prevention in Patients with Atrial Fibrillation
J. Clin. Med. 2018, 7(2), 32; https://doi.org/10.3390/jcm7020032
Received: 12 December 2017 / Revised: 29 January 2018 / Accepted: 2 February 2018 / Published: 12 February 2018
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Abstract
Non-surgical left atrial appendage occlusion has emerged as an alternative to anticoagulant therapy in the management of stroke risk in patients with atrial fibrillation. This review reports on some of the more common devices that are currently being used to manage patients in
[...] Read more.
Non-surgical left atrial appendage occlusion has emerged as an alternative to anticoagulant therapy in the management of stroke risk in patients with atrial fibrillation. This review reports on some of the more common devices that are currently being used to manage patients in this challenging group. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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Open AccessFeature PaperReview Robotic-Assisted Percutaneous Coronary Intervention: Rationale, Implementation, Case Selection and Limitations of Current Technology
J. Clin. Med. 2018, 7(2), 23; https://doi.org/10.3390/jcm7020023
Received: 19 December 2017 / Revised: 14 January 2018 / Accepted: 17 January 2018 / Published: 30 January 2018
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Abstract
Interventional cardiologists have witnessed an explosive growth in the field. A wide array of percutaneous procedures allow us to treat numerous cardiac conditions less invasively. However, the way we work has changed very little over the past decades. We continue to stand at
[...] Read more.
Interventional cardiologists have witnessed an explosive growth in the field. A wide array of percutaneous procedures allow us to treat numerous cardiac conditions less invasively. However, the way we work has changed very little over the past decades. We continue to stand at the tableside for prolonged periods of time, exposing ourselves to the very real risks of radiation exposure as well as to the associated orthopedic injuries from radiation protection. The precision of our procedures is limited by the distance from the fluoroscopic images and, furthermore, patients are potentially at risk from operator fatigue caused by a physician standing at the table for prolonged periods while wearing cumbersome radiation protection gear. Robotic-assisted coronary intervention removes the operator from the radiation field and has been shown to markedly reduce operator exposure as well as allow for more precise positioning of balloons and stents. This technology holds great promise for making interventional procedures safer and more comfortable for the operators as well as reducing fatigue, potentially improving patient outcomes. Currently, we are in an ‘early adopter’ phase of this technology and this paper reviews the rationale, methodology, optimal case selection, and limitations of robotic-assisted coronary intervention. Full article
(This article belongs to the Special Issue Advances in Interventional Cardiology and Vascular Medicine)
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