Recent Advances in Interventional Cardiology

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

Deadline for manuscript submissions: 20 April 2026 | Viewed by 691

Special Issue Editors


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Guest Editor
Medical Clinic Number 1, Internal Medicine Department, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
Interests: intracoronary imaging; mainly OCT; acute coronary syndromes; primary PCI
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Guest Editor Assistant
Medical Clinic Number 1, Internal Medicine Department, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400006 Cluj-Napoca, Romania
Interests: drug-coated balloons; intracoronary imaging; acute coronary syndromes; primary PCI; debulking; calcific lesions

Special Issue Information

Dear Colleagues,

Over the past decade the general landscape of interventional cardiology has been dramatically changed by new advancements which allow us to tackle increasingly complex lesions. Since the use of intracoronary imaging has become a routine practice for most complex cases and multiple debulking strategies have demonstrated their efficacy, a variety of lesions which were not long ago considered to be the Achille’s heel of interventional cardiology are currently being treated almost daily. Therefore, bifurcation lesions, highly calcific lesions, chronic total occlusions, acute coronary syndromes complicated with cardiogenic shock, multivessel disease, and diffuse lesions have modern solutions in current era, with very good long-term outcomes.

One of the most promising advancements is the growing role of drug-coated balloons (DCBs). Initially developed for in-stent restenosis, DCBs are routinely being used in small vessel disease, with promising results for various other de novo lesions. This popular approach has been studied in more and more complex scenarios, with encouraging results obtained; however, it is vital to gather data from larger trials in order to better understand the role of DCBs in this area.

With the increased availability of intracoronary imaging, the interventionalist’s ability to adjust therapy based on a person’s plaque morphology and lesion characteristics has never been greater. This imaging-guided precision has improved both acute procedural success and long-term outcomes, particularly in complex subsets such as left main disease and bifurcations.

Finally, the management of acute coronary syndromes (ACSs) continues to evolve with advances in both pharmacology and interventional techniques. There are still, however, multiple questions to be answered in complex ACS scenarios, including multivessel PCI in STEMI, plaque erosion-guided strategies, and the use of mechanical circulatory support in cardiogenic shock.

This Special Issue, titled “Recent Advances in Interventional Cardiology,” brings together cutting-edge research focusing on contemporary advances and future directions in percutaneous coronary intervention (PCI). The main topics of interest include, but are not limited to, advances in drug-coated balloons, new strategies for tackling calcific lesions, new approaches to complex bifurcation lesions, and current strategies regarding antithrombotic therapy and high-bleeding-risk patients. 

We invite the submission of original research articles, systematic reviews, meta-analyses, clinical studies, technical innovations, and expert perspectives.

Prof. Dr. Dan Mircea Olinic
Guest Editor

Dr. Florin-Leontin Lazar
Guest Editor Assistant

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Keywords

  • drug-coated balloon
  • acute coronary syndrome
  • primary PCI
  • CHIP patients and lesions
  • intracoronary imaging
  • bifurcation lesions
  • CTO

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Published Papers (1 paper)

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Research

20 pages, 7967 KB  
Article
OCT-Based Morphological Classification of Healed Coronary Plaques: Insights from Imaging of Fresh Thrombi at Different Stages of Healing and Implications for Post-Stenting Edge Dissections
by Calin Homorodean, Horea-Laurentiu Onea, Florin-Leontin Lazar, Mihai Claudiu Ober, Mihail Spinu, Dan-Alexandru Tataru, Maria Olinic, Ioana Rada Popa Ilie, Romana Homorodean, Daniel-Corneliu Leucuta and Dan-Mircea Olinic
Medicina 2025, 61(8), 1440; https://doi.org/10.3390/medicina61081440 - 10 Aug 2025
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Abstract
Background and Objectives: In vivo data on healed coronary plaques (HCPs), the hallmark of previous plaque disruption, remains scarce. The study aimed to use optical coherence tomography (OCT) imaging to assess the prevalence, morphological features, and clinical significance of culprit HCPs in [...] Read more.
Background and Objectives: In vivo data on healed coronary plaques (HCPs), the hallmark of previous plaque disruption, remains scarce. The study aimed to use optical coherence tomography (OCT) imaging to assess the prevalence, morphological features, and clinical significance of culprit HCPs in patients with acute coronary syndrome (ACS). Materials and Methods: A total of 87 ACS patients (74.3% non-ST-segment elevation ACS) who underwent pre-procedural OCT imaging of the culprit vessel at a single center were retrospectively analyzed. A pilot subgroup of patients with intracoronary thrombi at the culprit site, in various stages of organization and healing, enabled a detailed morphological characterization of HCP despite the absence of histological validation. Three distinct HCP imaging aspects were identified: type I—overlaying fibrous tissue, type II—overlaying lipid tissue, and type III—overlaying calcific tissue. HCP presence was subsequently assessed in the entire population. Clinical correlations included associations with post-stenting outcomes, particularly edge dissections (ED). Results: Culprit HCPs were identified in 78 patients (89.7%): type I—30.8%, type II—51.3%, and type III—17.9%. Regarding the underlying substrate and complication mechanism, type I HCP was associated with pathological intimal thickening (70.8%) and plaque erosion (75%), type II with lipid-rich plaque (80%) and plaque rupture (PR) (82.5%), and type III correlated with calcific plaque (92.9%, p < 0.0001) and both PR and calcified nodule (p < 0.0001). A unique signal-rich ring was observed at the HCP–tissue interface in both type II (77.5%) and type III (78.6%, p < 0.0001). There was a significant correlation between stent ED and HCP presence at landing zones (LZ) (HR 4.14, 95% CI: 1.79–9.55; p < 0.001). Conclusions: OCT analysis of intracoronary organizing fresh thrombi allowed detailed characterization of culprit HCPs and in vivo classification into three imaging types. This approach likely contributed to the high observed detection rate of HCP by enhancing recognition of subtle OCT features. HCP may create mechanical vulnerability if located at the stent LZ. Our improved HCP detection techniques may help optimize stent-related outcomes of OCT-guided procedures by choosing an HCP-free LZ or longer stents. Full article
(This article belongs to the Special Issue Recent Advances in Interventional Cardiology)
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