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Trends and Prospects in Percutaneous Coronary Intervention

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

Deadline for manuscript submissions: 27 June 2024 | Viewed by 4699

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Special Issue Editor

Dr. Fabien A. Picard

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Guest Editor

Institut Arnault Tzanck, Saint-Laurent-du-Var, France
Interests: critical care; ICU; interventional cardiology; cardiology

Special Issue Information

Dear Colleagues,

The treatment of patients with coronary artery disease, especially in the field of percutaneous coronary intervention has made tremendous progress with the development of dedicated devices such as new generation drug-eluting stents, drug-coated balloon, plaque modification devices and dedicated chronic total occlusion wires, microcatheters and techniques, as well as physiology, imaging, and pharmacologic drugs.

This Special Issue of the Journal of Clinical Medicine, entitled “JCM—Trends and Prospects in Percutaneous Coronary Intervention”, focuses on recent advances and perspectives in the interventional in the field of percutaneous coronary intervention. We invite to submit articles of significant clinical and scientific value, such as observational studies, state-of-the-art review articles and clinical trials on this topic. Case reports and short reviews are not accepted.

Dr. Fabien A. Picard
Guest Editor

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 submissions that pass pre-check are 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 semimonthly 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 2600 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.

Keywords

intracoronary physiology
intracoronary imaging
challenging coronary anatomy
complex high-risk patients
coronary artery disease
ischemic heart disease
acute coronary syndrome
chronic coronary syndrome
interventional cardiology

Published Papers (4 papers)

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Research

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10 pages, 821 KiB

Open AccessArticle

Impact of Scoring Balloon Angioplasty on Lesion Preparation for DCB Treatment of Coronary Lesions

by Eun-Seok Shin, Soe Hee Ann, Mi Hee Jang, Bitna Kim, Tae-Hyun Kim, Chang-Bae Sohn and Byung Joo Choi

J. Clin. Med. 2023, 12(19), 6254; https://doi.org/10.3390/jcm12196254 - 28 Sep 2023

Cited by 2 | Viewed by 1184

Abstract

Objective: The aim of this study was to evaluate the efficacy of scoring balloon angioplasty for drug-coated balloon (DCB) treatment in percutaneous coronary intervention. Background: The scoring balloon angioplasty may play a pivotal role in enhancing the outcomes of DCB treatment. Methods: A total of 259 patients (278 lesions) with coronary artery disease successfully treated with DCB were retrospectively enrolled. The mean age of the patients was 62.2 ± 11.1 years, and the majority of patients were men (68.7%). The study’s endpoint was defined as achieving an optimal angiographic result, which consisted of Thrombolysis in Myocardial Infarction (TIMI) flow grade 3, residual diameter stenosis ≤ 30%, and dissection less than type C after the procedure. Results: Angioplasty was performed for 61 lesions with a scoring balloon and 217 lesions with a non-scoring balloon. All lesions were TIMI flow grade 3 except two lesions in the non-scoring balloon group. The scoring balloon group had a higher prevalence of residual diameter stenosis ≤ 30% (68.9% vs. 39.6%, p < 0.001), while severe dissection, defined as type C or greater, was observed less frequently (9.8% vs. 31.8%, p = 0.001). Moreover, the scoring balloon group achieved a superior rate of optimal angiographic results (60.7% vs. 28.6%, p < 0.001). In multivariable analysis, scoring balloon (OR: 3.08 [95% confidence interval, 1.47–6.58], p = 0.003) and DCB balloon-to-artery ratios (OR: 5.46 [95% confidence interval, 1.43–21.93], p = 0.014) were independent factors in the increasing rate of optimal angiographic result. Conclusions: The application of a scoring balloon catheter for lesion preparation, aiming to make them suitable for DCB treatment, was associated with a decreased risk of severe dissection and a greater occurrence of optimal angiographic outcomes compared with non-scoring balloon angioplasty. Full article

(This article belongs to the Special Issue Trends and Prospects in Percutaneous Coronary Intervention)

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10 pages, 891 KiB

Open AccessArticle

Identification of Low- versus High-Risk Acute Coronary Syndrome for a Selective ECG Monitoring Strategy

by Mariama Akodad, Pierre-Alain Meunier, Caroline Padovani, Guillaume Cayla, Wassim Zitouni, Jean-Christophe Macia, Pierre Robert, Matthieu Steinecker, François Roubille and Florence Leclercq

J. Clin. Med. 2023, 12(14), 4604; https://doi.org/10.3390/jcm12144604 - 11 Jul 2023

Viewed by 991

Abstract

Background: While admission of patients with acute coronary syndromes (ACS) in cardiology intensive care unit (CICU) is usual, in-hospital major outcomes in lower risk patients may be evaluated after early coronary angiography according to the European guidelines. Methods: Consecutive ACS patients were prospectively included after coronary angiography evaluation within 24 h and percutaneous coronary intervention (PCI), when required. Patients were classified as high- or low-risk according to hemodynamics, rhythmic state, ischemic and bleeding risks. Major in-hospital outcomes were assessed. Results: From January to June 2021, 277 patients were enrolled (62.8% with ST-segment elevation myocardial infarction (STEMI) (n = 174); 37.2% with non-NSTEMI (NSTEMI) (n = 103). PCI was required for 260 patients (93.9%). Seventy-four patients (26.7%) were classified as low-risk (n = 47 NSTEMI; n= 27 STEMI) and 203 patients (73.3%) as high-risk of events. All patients were monitored in CICU. While 38 patients (18.7%) from the high-risk group reached the primary endpoint, mainly related to rhythmic or conduction disorder (n = 24, 11.8%) or unstable hemodynamics (n = 17; 8.4%), only 1 patient (1.3%) in the low-risk group had one major outcome (no fatal bleeding); p < 0.01. The negative predictive value of our patient stratification for the absence of major in-hospital outcome was 100% (CI95%: 100–100%) for STEMI and 97.9% [CI95%: 93.2–100%] for NSTEMI patients. Conclusions: Stratification of ACS patients after early coronary angiography and most of the time PCI, identify a population with very low risk of in-hospital events (1/4 of all ACS and 1/2 of NSTEMI) who may probably not require ECG monitoring and/or CICU admission. (NCT04378504). Full article

(This article belongs to the Special Issue Trends and Prospects in Percutaneous Coronary Intervention)

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11 pages, 1911 KiB

Open AccessArticle

Comparison of 7-Year, Real-World Clinical Outcomes between Drug-Coated Balloon Angioplasty versus Drug-Eluting Stent Implantation in Patients with Drug-Eluting Stent In-Stent Restenosis

by Minsu Kim, Albert Youngwoo Jang, Joonpyo Lee, Jeongduk Seo, Yong Hoon Shin, Pyung Chun Oh, Soon Yong Suh, Kyounghoon Lee, Woong Chol Kang and Seung-Hwan Han

J. Clin. Med. 2023, 12(13), 4246; https://doi.org/10.3390/jcm12134246 - 24 Jun 2023

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Abstract

There are no data available comparing the real-world, long-term clinical outcomes of drug-eluting balloon (DEB) angioplasty and drug-eluting stent (DES) implantation in DES in-stent restenosis (ISR) lesions. We aimed to compare the real-world, long-term data available between DEBs and DESs in DES-ISR lesions. We analyzed consecutive DES-ISR lesions (225 lesions from 205 patients; male: 66.3%; mean age: 62.4 years) treated with either DEB or DES. The primary endpoint was target lesion revascularization (TLR), and the primary safety endpoint was the lesion-oriented composite outcome (LOCO). The LOCO is composed of cardiac death, myocardial infarction, and target lesion thrombosis during follow-up. During the 7-year follow-up period, TLR did not differ significantly between the DEB (n = 108) and the DES groups (n = 117) (HR: 1.07; 95% CI: 0.59–1.93, p = 0.83). The LOCO was significantly lower in the DEB group compared to the DES group (HR: 0.40; 95% CI: 0.16–0.98, p = 0.04), which was mainly driven by the lower levels of myocardial infarction (HR: 0.24; 95% CI: 0.06–0.94, p = 0.04) and the absence of target lesion thrombosis in the DEB group (vs. DES group 6%, p = 0.02). Additionally, cardiac death was found to be similar between the DEB and DES groups (HR: 0.56; 95% CI: 0.18–1.75, p = 0.32). DEB angioplasty showed favorable safety with a similar efficacy to that of DES implantation in DES-ISR lesions during the long-term follow-up period. Full article

(This article belongs to the Special Issue Trends and Prospects in Percutaneous Coronary Intervention)

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Review

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18 pages, 2226 KiB

Open AccessReview

Percutaneous Coronary Intervention in Out-of-Hospital Cardiac Arrest Related to Acute Coronary Syndrome: A Literature Review

by Emmanuel Gall, Donia Mafi, Tahar Ghannam, Pierre Brami, Vincent Pham, Olivier Varenne and Fabien Picard

J. Clin. Med. 2023, 12(23), 7275; https://doi.org/10.3390/jcm12237275 - 24 Nov 2023

Viewed by 1233

Abstract

Out-of-hospital cardiac arrest (OHCA) continues to be a major global cause of death, affecting approximately 67 to 170 per 100,000 inhabitants annually in Europe, with a persisting high rate of mortality of up to 90% in most countries. Acute coronary syndrome (ACS) represents one of the most significant cause of cardiac arrest, and therefore invasive coronary angiography (CAG) with subsequent percutaneous coronary intervention (PCI) has emerged as a fundamental component in the management of OHCA patients. Recent evidence from large randomized controlled trials (RCTs) challenges the routine use of early CAG in the larger subgroup of patients with non-ST segment elevation myocardial infarction (NSTEMI). Additionally, emerging data suggest that individuals resuscitated from OHCA related to ACS face an elevated risk of thrombotic and bleeding events. Thus, specific invasive coronary strategies and anti-thrombotic therapies tailored to this unique setting of OHCA need to be considered for optimal in-hospital management. We sought to provide an overview of the prevalence and complexity of coronary artery disease observed in this specific population, discuss the rationale and timing for CAG after return of spontaneous circulation (ROSC), summarize invasive coronary strategies, and examine recent findings on antithrombotic therapies in the setting of ACS complicated by OHCA. By synthesizing the existing knowledge, this review aims to contribute to the understanding and optimization of care for OHCA patients to improve outcomes in this challenging clinical scenario. Full article

(This article belongs to the Special Issue Trends and Prospects in Percutaneous Coronary Intervention)

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