SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

The year in cardiology 2017: coronary interventions

█ Current opinion

Authors:
Steen Dalby Kristensen1*, Michael Maeng1, Davide Capodanno2,3, and William Wijns4
1Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99. 8200 Aarhus, Denmark
2Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria
“Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
3Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
4The Lambe Institute for Translational Medicine and Curam, National University of Ireland, Galway and Saolta University Healthcare Group, Galway, Ireland

Preamble

The first balloon coronary angioplasty was performed in Zurich by Andreas Grüntzig in 1977. The patient, a 38-year-old man with severe angina and a tight stenosis on the left anterior descending artery, is still alive, is doing well, and he celebrated the 40 year anniversary of his percutaneous coronary interventions (PCI) in 2017 (Figure 1). During the last decades, PCI techniques have undergone major improvements with the first real game changer being the introduction of bare metal stents, which made PCI safer and improved longer-term outcomes. Later on, drug-eluting stents (DESs) were introduced, which resulted in a major reduction in restenosis and also – with the newer generation DES – a low rate of stent thrombosis. Further, the introduction of intracoronary pressure measurements for assessment of severity of coronary stenosis [fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR)] and intracoronary imaging [intravascular ultrasound (IVUS) and optical coherence tomography (OCT)] for lesion assessment has refined lesion and procedure assessment. Improved outcomes were also fostered by development of better and safer adjunctive antithrombotic drugs and secondary prevention, optimizing drug-device synergy. Still, 40 years later the research in the coronary interventional field is very intense, and we aim here to summarize major developments in PCI published in 2017.

ISSUE: CARDIOLOGIA HUNGARICA | 2018 | VOLUME 48, ISSUE 5 

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