Interventional Cardiology

European and American experts recommend physiology-guided myocardial revascularisation.1,2,3 Nevertheless, physiology-guided revascularisation does not exceed 10% in the best scenario, worldwide.

Treating chronic total occlusions (CTO) by the antegrade approach requires appropriate devices and skill in resource-limited settings. Good guide-catheter support is crucial.1,2 Patients with diabetes and narrower radial arteries are prone to spasm with larger guiding catheters, and may benefit from a slender approach to percutaneous coronary intervention (PCI).

Bioresorbable vascular scaffolds (BRS) are a new and promising technology. BRS have been developed to provide the same advantages as drug-eluting stents, including radial strength, prevention of vessel recoil, and release of an antiproliferative drug.

Today, coronary flow reserve (CFR) is used to evaluate the microcirculation, but not the haemodynamic significance, of coronary stenosis. Fractional flow reserve (FFR) is the gold standard for this purpose, with a cut-off value of 0.8 for intervention. Its simplicity, however, limits its predictive value.

The development of interventional cardiology is inevitably associated with increased dose of ionising radiation for the physician.1 Additionally, physiology-guided myocardial revascularisation is supported by both European and American experts,2,3 but these procedures may increase the total procedure time in addition to increased dose of ionising radiation for the physician.

A significant proportion of patients undergoing coronarography due to chest pain have normal or near-to-normal coronary arteries…

Suboptimal lesion preparation and consequent stent under-expansion related to calcified coronary lesions are predictors of adverse outcomes in terms…

The optimal approach to coronary bifurcations treatment by percutaneous coronary interventions is still a subject of debate and dedicated bifurcation…