Current Perspectives and Future Directions in Vascular Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 30 July 2026 | Viewed by 883

Special Issue Editors


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Guest Editor
IRCCS Galeazzi St Ambrogio Hospital, Via Cristina Belgioioso 173, 20157 Milan, Italy
Interests: aortic valve stenosis; heart-valve; transcatheter aortic valve implantation; vascular complications; TAVI; aortic regurgitation; peripheral arterial disease
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Guest Editor Assistant
Department of Cardiovascular Science, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
Interests: limb salvage; diabetic foot care; endovascular interventions; peripheral arterial disease; angioplasty; stenting; bypass surgery; critical limb ischemia; vascular surgery outcomes; aortic biomechanics

Special Issue Information

Dear Colleagues,

Vascular surgery is evolving rapidly, driven by continuous innovation, refined imaging technologies, and the widespread adoption of endovascular and hybrid techniques. Over the past decades, the field has expanded its boundaries, from complex aortic reconstruction to distal limb salvage, achieving remarkable progress in patient safety, procedural precision, and recovery. These advances have reshaped traditional paradigms, yet they also bring new challenges related to durability, reintervention, and equitable access to advanced care.

The aim of this Special Issue, “Current Perspectives and Future Directions in Vascular Surgery”, is to provide a comprehensive overview of recent developments and to highlight future directions that will shape the next generation of vascular care. Topics of interest include innovations in endovascular and open surgery, hybrid approaches, imaging and navigation technologies, perioperative optimization, outcome durability, and the integration of artificial intelligence and personalized medicine.

We invite original research articles, reviews, and expert perspectives that explore cutting-edge techniques, novel devices, and multidisciplinary strategies for improving vascular outcomes. By bringing together diverse expertise, this Special Issue seeks to foster collaboration, stimulate discussion, and inspire innovation across the global vascular community.

Dr. Alfonso Ielasi
Guest Editor

Dr. Luca Galassi
Guest Editor Assistant

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Keywords

  • vascular surgery
  • endovascular repair
  • hybrid techniques
  • aortic disease
  • peripheral arterial disease
  • surgical innovation
  • precision medicine

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Published Papers (1 paper)

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5 pages, 195 KB  
Opinion
Are Coronary Calcium-Modifying Techniques Levelling the Playfield?
by Georgiana Pintea Bentea and Pierre-Emmanuel Massart
Medicina 2026, 62(4), 782; https://doi.org/10.3390/medicina62040782 - 17 Apr 2026
Viewed by 425
Abstract
Patients with heavily calcified coronary arteries represent a challenge in percutaneous coronary intervention (PCI), as severe calcification impairs device delivery and limits optimal stent expansion, leading to higher risks of stent thrombosis, restenosis, and adverse clinical outcomes. Approximately 20% of patients undergoing PCI [...] Read more.
Patients with heavily calcified coronary arteries represent a challenge in percutaneous coronary intervention (PCI), as severe calcification impairs device delivery and limits optimal stent expansion, leading to higher risks of stent thrombosis, restenosis, and adverse clinical outcomes. Approximately 20% of patients undergoing PCI exhibit severe coronary calcification, which independently predicts incomplete revascularization, increased mortality, and higher rates of major adverse cardiovascular events over mid-term follow-up. Recent advances have focused on improving the assessment and management of calcified lesions. Intracoronary imaging modalities, including intravascular ultrasound and optical coherence tomography, allow precise detection and characterization of calcium burden, overcoming the limitations of angiography. These tools play a pivotal role in guiding procedural strategy, enabling tailored selection of calcium-modifying techniques based on lesion morphology, and optimizing stent deployment. Technological innovations have significantly expanded therapeutic options. While non-compliant balloon angioplasty alone is often insufficient, adjunctive devices such as cutting and scoring balloons improve plaque modification in focal disease. Atherectomy techniques, including rotational and orbital systems, are effective for more complex lesions but require technical expertise and carry procedural risks. Intravascular lithotripsy has emerged as a promising, less aggressive modality capable of fracturing deep calcium, while excimer laser atherectomy offers an alternative for resistant lesions. Despite these advances, current evidence supporting calcium-modifying strategies is largely based on procedural outcomes rather than definitive improvements in long-term clinical endpoints. Meta-analyses and randomized trials have not demonstrated clear superiority of any single technique, and most studies remain underpowered. Intriguingly, recent data suggest that outcomes in treated calcified lesions may approximate those of non-calcified disease, raising the hypothesis that these technologies could mitigate the adverse impact of calcification. However, this remains unproven, highlighting the urgent need for adequately powered randomized trials to determine their true clinical benefit. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Vascular Surgery)
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