The International Journal Of Angiology[JOURNAL]
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200 papers
Atrial Fibrillation After Coronary Artery Bypass Grafting: A Single-Center Study.
Armagno D, Saha S
Int J Angiol · 2026 Jun · PMID 42137767 · Full text
Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG), associated with increased morbidity and health care costs. This study examines the incidence and impact...
Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG), associated with increased morbidity and health care costs. This study examines the incidence and impact of POAF on outcomes in CABG patients at a single institution. This retrospective observational study included patients undergoing isolated CABG between 2006 and 2022, excluding those with preoperative atrial fibrillation. Data include demographics, length of stay (LOS), mortality, and complications (Bleeding, stroke, and infection rates), comparing outcomes in patients with and without POAF. Among 2,671 patients, 238 (8.9%) developed POAF. POAF patients had higher rates of infection (7.56 vs. 5.75%), postoperative bleeding (5.04 vs. 2.84%), and stroke (5.46 vs. 2.01%). Thirty-day, 2-year, and 5-year mortality rates were 1.3, 7.8, and 24%, respectively. Intensive care unit (ICU) and hospital LOS were also prolonged in POAF patients as well. A total of 63.6 and 8.44% of POAF patients were discharged within 5 days from the hospital and ICU, respectively. Compared with 73.1 and 15.8% of non-POAF patients experienced no complications. POAF significantly impacts CABG patient outcomes, increasing morbidity, mortality, and resource utilization. Monitoring and early intervention are essential to mitigate these effects.
Navigating Through Catastrophe: Successful Unsheathed Stent Extraction in Acute Myocardial Infarction.
Shah J, Senapati S, Siddiqui T … +1 more , Mukherjee D
Int J Angiol · 2026 Jun · PMID 42137764 · Full text
Stent detachment during coronary angioplasty may lead to life-threatening complications. Existing retrieval techniques may exacerbate risks, especially in narrow vessels. This case report introduces a rarely utilized wir...
Stent detachment during coronary angioplasty may lead to life-threatening complications. Existing retrieval techniques may exacerbate risks, especially in narrow vessels. This case report introduces a rarely utilized wire braiding technique for stent retrieval, demonstrating its efficacy in a critical situation. A 55-year-old male with STEMI underwent an attempt at a complex angioplasty, resulting in stent detachment. Traditional retrieval methods were unsuccessful due to anatomical constraints. The wire braiding technique involved maneuvering a secondary buddy wire through the stent struts, interweaving with the primary wire, and extracting the stent. This versatile method can be utilized in confined spaces. This report illustrates the importance of the wire braiding technique as a means of minimizing procedural risks associated with stent detachment.
Comparative Evaluation of Transthoracic Echocardiography and Multislice Computed Tomography in the Preoperative Assessment of Tetralogy of Fallot.
Hoang V, Tra GT, Van DT … +2 more , Dang DN, Ngoc DT
Int J Angiol · 2026 Jun · PMID 42137763 · Full text
BACKGROUND: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, requiring precise anatomical assessment for optimal surgical planning. Transthoracic echocardiography (TTE) and multislice compu...
BACKGROUND: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, requiring precise anatomical assessment for optimal surgical planning. Transthoracic echocardiography (TTE) and multislice computed tomography (MSCT) are widely used imaging modalities for TOF evaluation, yet their relative diagnostic value, particularly in infants, remains an area of active investigation. This study aims to compare the diagnostic performance of TTE and MSCT in assessing intracardiac and extracardiac abnormalities in infants with TOF, with surgical findings as the reference standard. MATERIALS AND METHODS: A prospective, single-center study was conducted on 35 infants diagnosed with TOF who underwent both TTE and 128-slice MSCT before surgical repair. Imaging findings were compared with intraoperative measurements, evaluating the sensitivity, specificity, and agreement (Cohen's kappa) between modalities. RESULTS: TTE and MSCT demonstrated comparable accuracy in assessing intracardiac abnormalities, with TTE showing slightly better agreement with surgical findings for ventricular septal defect (VSD) localization (κ = 0.581) than MSCT (κ = 0.485). Both modalities underestimated VSD size compared with intraoperative measurements, with MSCT showing a greater degree of underestimation ( < 0.001). In contrast, MSCT exhibited superior sensitivity in detecting extracardiac abnormalities, including coronary artery anomalies (100 vs. 50%) and major aortopulmonary collateral arteries (90 vs. 25%). While higher-generation MSCT scanners offer improved image resolution, the use of a 128-slice MSCT scanner proved to be a feasible alternative when more advanced technology is unavailable. CONCLUSION: TTE remains a reliable imaging modality for intracardiac assessment and is not inferior to MSCT in evaluating cardiac deformities in TOF. However, MSCT provides superior anatomical delineation of extracardiac structures, making it valuable for comprehensive preoperative planning. Despite its operator dependency, TTE remains the preferred first-line imaging tool due to its noninvasiveness and real-time functional assessment, whereas MSCT serves as a complementary modality, particularly for extracardiac evaluation. Further multicenter studies with larger cohorts are warranted to refine imaging protocols and optimize TOF assessment strategies in infants.
Bilateral Functional Popliteal Artery Entrapment Syndrome: A Rare Familial Occurrence.
Judickas SJ, Epstein DA, Zarebski SA
Int J Angiol · 2026 Jun · PMID 42137760 · Full text
Functional popliteal artery entrapment syndrome (FPAES) is a rare disorder most commonly affecting young, athletic females. We report a case of two sisters, both collegiate athletes, found to have bilateral FPAES confirm...
Functional popliteal artery entrapment syndrome (FPAES) is a rare disorder most commonly affecting young, athletic females. We report a case of two sisters, both collegiate athletes, found to have bilateral FPAES confirmed with magnetic resonance imaging and conventional dynamic angiography. In both cases, imaging demonstrated near occlusion of bilateral suprageniculate popliteal arteries during active plantarflexion. Both patients were then treated with medial head gastrocnemius myomectomy. One sister achieved complete resolution of symptoms with no recurrence at 2-year follow-up. The other sister developed recurrent symptoms and was treated with a revisional soleal sling release. This study highlights the rarity of the disorder among siblings and also provides a review of the diagnostic and management approaches for FPAES.
Successful Endovascular Treatment for Ruptured Atypical Aortoiliac Mycotic Aneurysm Cause from : A Case Report.
Worathanmanon S, Kritpracha B, Tantarattanapong W … +3 more , Jantarapatin P, Srianakkawanich P, Rookkapan S
Int J Angiol · 2026 Jun · PMID 42137756 · Full text
Mycotic aneurysms, a rare condition (0.6-1.3% incidence), pose significant mortality risks if untreated, even with surgical intervention. Diagnosis challenges arise from nonspecific presentations. An integrated approach...
Mycotic aneurysms, a rare condition (0.6-1.3% incidence), pose significant mortality risks if untreated, even with surgical intervention. Diagnosis challenges arise from nonspecific presentations. An integrated approach involving clinical suspicion, examinations, inflammatory markers, blood culture, and imaging is crucial. While emerging endovascular treatments exist, conventional methods like surgical resection remain pivotal. This report highlights a unique case-a ruptured infected aortoiliac aneurysm caused by -successfully treated with an endovascular strategy. The patient demonstrated favorable outcomes during a 17-month follow-up period.
Doppler Flowmeter Aids in Successful Pediatric Arteriovenous Fistula Repair.
Tanimoto K, Miyake K, Kido T … +2 more , Taira M, Miyagawa S
Int J Angiol · 2026 Jun · PMID 42137755 · Full text
Detecting residual arteriovenous fistula (AVF) in small children is challenging. We report a case of a pediatric patient who required a reoperation for an iatrogenic femoral AVF due to an undetected residual AVF during t...
Detecting residual arteriovenous fistula (AVF) in small children is challenging. We report a case of a pediatric patient who required a reoperation for an iatrogenic femoral AVF due to an undetected residual AVF during the initial operation. Using a bidirectional Doppler volume flowmeter was helpful in ensuring complete resection. A 4-year-old girl with univentricular congenital heart disease and multiple surgeries for univentricular repair was referred for an iatrogenic right femoral AVF after several diagnostic and therapeutic catheterizations. Angiography before Fontan operation revealed the AVF, necessitating surgical intervention concomitantly. Initially, the AVF was ligated, and no residual AVF was detected by palpation. However, 1 year later, angiography and duplex ultrasound showed a residual AVF, causing a hemodynamic burden. Concerns about potential leg length discrepancy and elevated inferior vena cava pressure led to a reoperation. The AVF was divided: ligated, transected, and oversewn. Postoperative Doppler confirmed the absence of turbulent flow and normalized blood flow patterns. She had an uneventful recovery and was discharged the next day. Two weeks later, duplex ultrasound confirmed no residual AVF, with normalized blood flow in the right external iliac artery.
Patient with Acute-On-Chronic Cholecystitis Complicated by Portal Vein Thrombosis Following "Long COVID-19": A Case Report.
Liu A, Hodkiewicz VA, Benson M … +2 more , Patel M, Roach P
Int J Angiol · 2026 Jun · PMID 42137753 · Full text
Portal vein thrombosis (PVT) is a rare but serious complication of hypercoagulable states or conditions that increase portal pressure, such as liver cirrhosis, inherited or acquired coagulation cascade abnormalities, mye...
Portal vein thrombosis (PVT) is a rare but serious complication of hypercoagulable states or conditions that increase portal pressure, such as liver cirrhosis, inherited or acquired coagulation cascade abnormalities, myeloproliferative disorders, malignancy, inflammation, or infection. COVID-19 has been associated with a prothrombotic state, leading to both arterial and venous thromboses. Here, we present a patient with minimal hypercoagulable risk factors who presented with PVT and acute-on-chronic cholecystitis with bacteremia, likely provoked by residual hypercoagulability from a "long COVID-19" syndrome. An 81-year-old male developed PVT as a complication of acute-on-chronic cholecystitis, with contributing factors potentially including hypercoagulability related to prior COVID-19 infection more than 4 months prior. PVT should remain a diagnostic consideration in patients with various hypercoagulable risk factors, including long COVID-19, who present with relevant clinical findings. There should be a low threshold for the pursuit of further diagnostic imaging, given the serious consequences of delayed diagnosis.
Pivotal Trials in Heart Failure in 2024-Putting Evidence into Clinical Practice!
Thandi P, Pradhan A, Behera SK
Int J Angiol · 2026 Mar · PMID 41705088 · Full text
The intricate interplay of physiological, psychological, and social factors presents considerable challenges in addressing heart failure. It is imperative to comprehend the epidemiology and pathophysiology, identify pred...
The intricate interplay of physiological, psychological, and social factors presents considerable challenges in addressing heart failure. It is imperative to comprehend the epidemiology and pathophysiology, identify predictors and their influence on clinical outcomes, and effectively utilize the diagnostic tools. Such evidence is vital for formulating innovative therapeutic strategies to decelerate the growing heart failure epidemic. As of 2024, the field of heart failure has witnessed significant advancements in therapies applicable to both heart failure with preserved and reduced ejection fraction. Recent studies in this domain yielded valuable insights into the latest developments in cardiovascular medicine, which possess the potential to revolutionize treatment strategies. These advancements advocate for a more integrated approach to patient care and aim to enhance overall clinical outcomes. Below is a concise overview of key studies showcased at scientific meetings over the past year, which promise to improve heart failure management.
Peripheral Arterial Interventions with Reduced Contrast Use: The Save Contrast Study.
Shammas AN, Shammas NW, Shammas GA … +1 more , Jones-Miller S
Int J Angiol · 2026 Mar · PMID 41705087 · Full text
BACKGROUND: Contrast volume is a predictor of the occurrence of radiocontrast nephropathy and is associated with a high rate of in-hospital mortality and morbidity. Several strategies have been outlined to reduce contras...
BACKGROUND: Contrast volume is a predictor of the occurrence of radiocontrast nephropathy and is associated with a high rate of in-hospital mortality and morbidity. Several strategies have been outlined to reduce contrast volume in the angiographic laboratory. Peripheral arterial endovascular procedures can be lengthy and tend to be associated with the use of high volumes of contrast. In this study, we tested specific interventions intended to reduce contrast volume in the angiographic laboratory during peripheral arterial procedures. MATERIALS AND METHODS: Fifty consecutive procedures (36 patients) who underwent peripheral arterial interventions at a single center were retrospectively reviewed for demographics, clinical, procedural, and major adverse events (MAE) immediately prior to the implementation of a prospective protocol to reduce contrast use in the angiographic laboratory (group A). Following protocol implementation, 50 additional consecutive procedures (42 patients) were prospectively enrolled (group B). The protocol required diluting contrast concentration to a 2:1 dilution for larger vessels and 3:1 for infrapopliteal vessels, the use of selective injections, digital subtraction angiography, a ruler, road mapping, and intravascular ultrasound. The primary endpoint was acute procedural success, defined as achieving <30% residual narrowing with no intraprocedural complications. A primary safety endpoint was MAE at 30 days, which included unplanned amputation, total mortality, or target lesion revascularization. Descriptive and comparative analyses were performed between the two groups. RESULTS: In groups A and B, 14 and 8 patients had staged procedures, respectively, and were analyzed only once for demographics and clinical characteristics. All patients were analyzed for clinical, angiographic, procedural, and 30-day outcomes. No differences were found in total treated length (mm) or chronic limb-threatening ischemia ( = 0.748). More chronic total occlusions were noted in group B than group A (42.3% vs. 24.2%; = 0.011). Residual stenosis was significantly more in group B than group A (15.4 ± 23.8% vs. 6.7 ± 6.7%, respectively; = 0.015). Contrast use was markedly reduced in group B versus group A (90.4 ± 61.3 cc vs. 221.2 ± 84.7 cc, respectively; < 0.001). MAE were similar in both groups. CONCLUSION: Contrast use can be significantly reduced during peripheral arterial interventions with the implementation of a few simple measures. A statistically nonsignificant decrease in procedural success and an increase in distal embolizations and perforations were noted in the low contrast group. Larger, randomized studies are needed to determine the overall safety of this low contrast approach in peripheral arterial interventions.
Aortic Atherosclerosis: An Updated Review of Current Guidelines and Management Approach-A Literature Review.
Mubder M, Dugal J, Houshmand N … +1 more , Tak T
Int J Angiol · 2026 Mar · PMID 41705086 · Full text
Aortic atheroma (AA) is defined by the development of atherosclerotic plaques within the aorta wall and is associated with unfavorable cardiovascular outcomes such as cryptogenic stroke, systemic embolism, and other majo...
Aortic atheroma (AA) is defined by the development of atherosclerotic plaques within the aorta wall and is associated with unfavorable cardiovascular outcomes such as cryptogenic stroke, systemic embolism, and other major adverse cardiac events (MACE). The clinical significance of AA is discussed in this review along with its relationship to cardiovascular outcomes. The purpose of this review article is to present a thorough summary of the current state of knowledge on AA, including its pathogenesis, classifications and grading systems, clinical implications, methods for diagnosis and imaging, therapeutic modalities and treatments, and lastly pertinent complications. There are various methods of AA classification or grading, which entail scoring extent of disease via plaque thickness, severity of atherosclerosis, or by the presence of mobile components or ulcerations. The implications of AA as a systemic atherosclerotic process on the development of coronary artery disease and MACE include, but are not limited to, vascular diseases such as strokes or peripheral arterial disease. The diagnostic approaches include multiple invasive and noninvasive imaging modalities. The treatment strategies range from prevention to medical therapy to invasive surgical interventions. The present evaluation highlights the significance of sustained investigation and advancement in the domain of aortic atherosclerosis to augment precision in diagnosis and effectiveness of treatment.
Social Determinants of Health and Effects on Cardiovascular Disease.
Amireh K, Makaryus AN
Int J Angiol · 2026 Mar · PMID 41705084 · Full text
Research has shown that social determinants of health (SDOH) can influence health outcomes by up to 30 to 55% and can account for 80 to 90% of a person's health status. Our review evaluates SDOH in cardiovascular disease...
Research has shown that social determinants of health (SDOH) can influence health outcomes by up to 30 to 55% and can account for 80 to 90% of a person's health status. Our review evaluates SDOH in cardiovascular disease patients and assesses their impact in the field of cardiology as evidenced by research in the literature. Such SDOH as housing availability, access to healthy foods, access to transportation, access to medications, quality of living conditions, quality of schooling, and many other factors, have a great impact upon our patients' outcomes. Nowhere is this more true than in the field of cardiovascular disease, which is the leading cause of death worldwide. By recognizing SDOH and managing them through detection and prevention, patient outcomes can be affected in a positive direction. The key to being successful in this endeavor is to improve our patients' health literacy, promote prevention, and ameliorate the negative factors that affect health outcomes.
Machine Learning-Based Ensemble Predictive Model for Cardiovascular Disease Prevention.
Kumar N, Agarwal R, Sharma LK … +1 more , Vashisth R
Int J Angiol · 2026 Mar · PMID 41705083 · Full text
Cardiovascular diseases (CVDs) are a primary cause of death globally, with an increasing incidence in India. Machine learning (ML) has emerged as a viable approach for CVD prediction; however, dataset size and generaliza...
Cardiovascular diseases (CVDs) are a primary cause of death globally, with an increasing incidence in India. Machine learning (ML) has emerged as a viable approach for CVD prediction; however, dataset size and generalizability limit model robustness. This study aims to develop an enhanced ML prediction model for CVD detection using ensemble methods. Six datasets were considered, including 7,916 records with clinical parameters. The records were classified into Dataset 1 ( = 3,676) and Dataset 2 ( = 4,240) based on available features to establish a feature set. Dataset 1 underwent analysis utilizing two approaches: binary classification of target variable (0: absence of CVD, 1: presence of CVD) and multiclass classification of target variable (based on CVD severity). Likewise, Dataset 2 underwent further analysis using binary classification of target variable (risk of CVD in 10 years). Identical data preprocessing and exploratory data analysis steps were performed for both dataset groups. Subsequently, 18 ML algorithms were used to develop distinct models for both dataset groups, from which picked the top 10 performing models. The Voting Classifier was used to build an ensemble model to integrate the models and enhance predictive performance. In the case of Dataset 1, our framework was obtained an accuracy of 96.5% in binary classification and 85.5% in multiclass classification. Similarly, our framework achieved an accuracy of 81.18% for Dataset 2. Utilizing ensemble modeling and an extensive dataset, our framework surpasses traditional and existing ML models in predicting stability, mitigating bias and improving decision support in CVD detection.
Investigation of the Survival Time of Patients Who Underwent Endovascular Treatment Due to Type 3 Aortic Dissection and Factors Affecting This Duration.
Işık M, Günerhan Y, Tanyeli Ö … +2 more , Yıldırım S, Demiray A
Int J Angiol · 2026 Mar · PMID 41705082 · Full text
OBJECTIVE: This study aimed to analyze the survival time of patients who underwent thoracic endovascular aortic replacement (TEVAR) due to acute type 3 aortic dissection and to investigate comorbid conditions and dissect...
OBJECTIVE: This study aimed to analyze the survival time of patients who underwent thoracic endovascular aortic replacement (TEVAR) due to acute type 3 aortic dissection and to investigate comorbid conditions and dissection characteristics that affect survival time. MATERIALS AND METHODS: Between 2013 and 2023, 94 patients who underwent TEVAR for type 3 dissection were retrospectively investigated. Survival time and factors affecting this time (comorbidity and dissection characteristics) were analyzed. RESULTS: The most common comorbidities were hypertension (88%). There was no significant difference between the demographic data of surviving and deceased patients. During the follow-up period, 57% of the patients survived, and 43% of the patients died. The mean survival time after TEVAR was 20.1 (0-108) months among patients who died and 47.7 (2-120) months for patients who lived. The mean number of comorbidities was 2.13 in patients who died and 2.25 in patients who survived. Survival distribution according to the type of interventional procedure was 50% for partial closure of the subclavian artery, 38.1% for complete closure, and 66.2% for closure starting from the distal subclavian artery ( = 0.06). Survival rate was significantly higher in patients who underwent reintervention ( = 0.005). Mortality was 9.5% in the early period, 25.5% in the first year, 29.7% in the second year, 34% in the third year, and 39.3% in the first 5 years. CONCLUSION: In our study, the survival rate was higher in patients who were followed regularly, and reintervention was applied when necessary. Therefore, we believe that undetected or untreated complications after TEVAR, rather than comorbid conditions, negatively affect survival more.
Cumulative Serum Endothelin-1 and Endothelin-3 Level Predicts 1-year Adverse Cardiac Events after ST-Elevation Acute Myocardial Infarction.
Putri AK, Hartopo AB, Puspitawati I … +1 more , Setianto BY
Int J Angiol · 2026 Mar · PMID 41705080 · Full text
Endothelin-1 (ET-1) and endothelin-3 (ET-3) released in circulation during acute myocardial infarction (AMI) contribute to vasoconstriction, which elevates the severity of the myocardial infarction. This study aims to in...
Endothelin-1 (ET-1) and endothelin-3 (ET-3) released in circulation during acute myocardial infarction (AMI) contribute to vasoconstriction, which elevates the severity of the myocardial infarction. This study aims to investigate the role of cumulative ET-1 and ET-3 levels on the major adverse cardiac events (MACE) 1 year after AMI hospitalization. This retrospective cohort study included patients with ST-elevation acute myocardial infarction (STEMI). Baseline data were collected, including sociodemographic characteristics, clinical data, and serum ET-1 and ET-3 levels, measured with ELISA assay. Follow-up was performed 1 year after hospital discharge to identify MACE. A multivariate logistic regression was performed to describe predictors of 1-year MACE. A total of 81 subjects were enrolled and followed up. Subjects were divided into two groups based on their cumulative ET-1 and ET-3 levels, using a rounded cut-off point of 17.0 ng/mL, produced by the ROC curve for MACE. At 1 year MACE occurred in 24 (29.3%) subjects. A multivariate analysis demonstrated that a cumulative ET-1 and ET-3 level >17.0 ng/mL was independently associated with 1-year MACE (aOR = 5.34, 95% CI: 1.36-21.07, = 0.017). A higher cumulative serum ET-1 and ET-3 level at admission predicts MACE in 1 year of follow-up after STEMI.
Aneurysmal Coronary Artery Disease: A Contemporary and Comprehensive Review.
Mubder M, Ramazani N, Tasouli-Drakou V … +2 more , Houshmand N, Tak T
Int J Angiol · 2025 Dec · PMID 41210678 · Full text
Coronary artery aneurysm (CAA) is a focal enlargement of the coronary artery exceeding 1.5 times the diameter of the adjacent normal segment of the vessel. The reported prevalence of CAA varies widely from 0.2 to 10%, wi...
Coronary artery aneurysm (CAA) is a focal enlargement of the coronary artery exceeding 1.5 times the diameter of the adjacent normal segment of the vessel. The reported prevalence of CAA varies widely from 0.2 to 10%, with male predominance and a predilection for the right coronary artery. Atherosclerosis is the main cause in adults and Kawasaki disease in children. While often asymptomatic, CAA may present with angina, myocardial infarction, or possible fatal complications such as rupture, compression of adjacent cardiopulmonary structures, thrombus formation, and distal embolization. CAA is usually an incidental finding during coronary angiography; however, advancements in cardiac imaging have enhanced the detection and characterization of CAA. Coronary computed tomography angiography and magnetic resonance angiography offer alternatives to traditional approaches with high-resolution images that can help with risk stratification and management planning. Management varies based on the size, location, complications, and presence of symptoms. It includes medical therapy, percutaneous intervention, and surgical approach. In this paper, we aim to provide a comprehensive review of current knowledge of CAA and recent advances in its diagnosis and management.
The History of Coronary Artery Disease.
Gorton AJ, Saha SP
Int J Angiol · 2025 Dec · PMID 41210677 · Full text
Coronary artery disease (CAD) is the leading cause of mortality worldwide and although often considered a modern disease its origins trace back to ancient civilizations. This historical review explores the evolution of u...
Coronary artery disease (CAD) is the leading cause of mortality worldwide and although often considered a modern disease its origins trace back to ancient civilizations. This historical review explores the evolution of understanding, diagnosis, and treatment of CAD. It will discuss early evidence of atherosclerosis in mummies through pioneers in the field of medical and surgical understanding to innovative surgical and interventional advances in the modern era. The progression of medical therapies, including the discovery and utilization of digitalis, nitrates, aspirin, beta blockers, and statins, is discussed alongside the evolution of catheter-based and surgical interventions such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Future therapies will be briefly discussed. Despite remarkable progress, CAD remains a major public health challenge, emphasizing the importance of continued innovation in prevention, diagnosis, and treatment. Understanding the historical trajectory of CAD provides critical insights for shaping the future of cardiovascular medicine.
Coronary Intervention: History and Current Status.
Glazier CR, Glazier JJ
Int J Angiol · 2025 Dec · PMID 41210676 · Full text
On September 16, 1977, Dr Andreas Roland Grüntzig performed the world's first successful percutaneous transluminal coronary angioplasty at the University Hospital Zurich, Switzerland. This spectacular event ushered in th...
On September 16, 1977, Dr Andreas Roland Grüntzig performed the world's first successful percutaneous transluminal coronary angioplasty at the University Hospital Zurich, Switzerland. This spectacular event ushered in the era of interventional cardiology. The technique has had a major influence on the practice of cardiology, right up to the current day. While Grüntzig remains the undisputed father of interventional cardiology, the observations and techniques developed by preceding pioneers in the fields of angiology, radiology, cardiology, and vascular and cardiac surgery paved the way for this procedure. Coronary stents were first developed by Ulrich Sigwart and his team in Lausanne, Switzerland. The aim of the stents was to reduce the considerable rates of restenosis and abrupt closure associated with balloon angioplasty. Current second-generation drug-eluting stents have very low abrupt closure and restenosis rates. Drug-eluting stents have performed favorably when compared with coronary artery bypass surgery in the treatment of patients with complex coronary artery disease. It is estimated that, in approximately one-third of such patients, treatment with these stents is an excellent alternative to coronary artery bypass surgery. Currently, coronary angioplasty with drug-eluting stents remains the preferred treatment of acute myocardial infarction, provided this can be done in timely fashion. With regard to patients with acute coronary syndrome, the benefit for angioplasty is greatest for those patients at moderate to high risk for cardiac complications. It is now accepted that most patients with stable ischemic heart disease are best managed with medical treatment rather than angioplasty.
Spontaneous Coronary Artery Dissection Clinical Review: Current State of Evidence and Challenges Ahead.
Halabi ZR, Garcia RT, Schreiber TL … +1 more , Kaki A
Int J Angiol · 2025 Dec · PMID 41210675 · Full text
Spontaneous coronary artery dissection (SCAD) has been increasingly recognized as a potentially serious nonatherosclerotic condition that can mimic atherosclerotic acute coronary syndromes. This condition has been identi...
Spontaneous coronary artery dissection (SCAD) has been increasingly recognized as a potentially serious nonatherosclerotic condition that can mimic atherosclerotic acute coronary syndromes. This condition has been identified as presenting with the classical clinical and electrocardiographic features that are encountered with acute coronary syndromes. Its formal identification has been historically challenging and difficult. A high index of clinical suspicion before invasive coronary angiography depends on the presence of some inherited and acquired risk factors. Early suspicion plays a key role in the identification of SCAD lesions during coronary angiography. Multiple angiographic features may be present, thus resulting in different types of SCAD lesions. Acute SCAD management favors conservative approaches for stable cases, with revascularization for high-risk presentations. Pharmacotherapy typically includes antiplatelet agents and β-blockers, avoiding routine anticoagulation. Long-term care involves recurrence prevention, monitoring, counseling, and screening for extra coronary fibromuscular dysplasia. Significant areas of uncertainty remain, as this relates to the best long-term management and surveillance strategies. This review aims to summarize the current state of knowledge and evidence, while pointing out the remaining challenges and the need for additional research.
Life after Coronary Artery Bypass Grafting: Lifestyle Changes, Secondary Prevention, and Quality of Life.
Chhabra J, Mubder M, Tak N … +4 more , Houshmand N, Siddiqui A, Cyrus T, Tak T
Int J Angiol · 2025 Dec · PMID 41210674 · Full text
Approximately 200 million people worldwide suffer from ischemic heart disease. Coronary artery bypass grafting (CABG) is known as a treatment option for multivessel and left main coronary artery disease, with better surv...
Approximately 200 million people worldwide suffer from ischemic heart disease. Coronary artery bypass grafting (CABG) is known as a treatment option for multivessel and left main coronary artery disease, with better survival rates and lower major adverse cardiac events compared with medical therapy or percutaneous cardiovascular intervention alone in several cases. Lifestyle following CABG has been written about extensively; however, the creation of a general, evidence-based guide for both patients and physicians across different specialties appears necessary, given the overwhelming amount of literature available, the continued refinement of guidelines, and technological advancements over time. We reviewed the latest data on CABG in both the United States and worldwide, utilizing consensus statements from the American Heart Association/American College of Cardiology and European Society of Cardiology literature, as well as the PubMed database and UpToDate, to obtain the most up-to-date information on these topics. We then organized our findings into multiple categories detailing surgical techniques, postoperative care, medication types, long-term prognosis, the importance of cardiopulmonary rehabilitation, as well as future directions.
Coronary Stents: All Those Trials.
Glazier MM, Glazier JJ
Int J Angiol · 2025 Dec · PMID 41210673 · Full text
In the nearly 40 years that have elapsed since the first coronary stent implantation in man, there has been a multitude of trials regarding this procedure. Stents were designed to combat two major weaknesses of balloon a...
In the nearly 40 years that have elapsed since the first coronary stent implantation in man, there has been a multitude of trials regarding this procedure. Stents were designed to combat two major weaknesses of balloon angioplasty: a high restenosis rate (>30%) and a 2 to 10% rate of abrupt closure. Early trials by some of the pioneers of the field suggested that stents, by scaffolding the artery, were indeed very successful in treating angioplasty-induced flow-limiting dissections. Findings of the BENESTENT-I (Belgian Netherlands stent trial) and STRESS (Stent Restenosis Study) demonstrated that stents reduced the restenosis rate to <30%. Drug-eluting stents were developed to further reduce the restenosis rates. In the SIRIUS trial (Sirolimus-Eluting Stents versus Standard Stents in Patients with Stenosis in a Native Coronary Artery), when compared with a bare metal stent, a sirolimus-eluting stent reduced significantly the need for revascularization of target lesions. Concerns regarding late and very late stent thrombosis with these first-generation drug-eluting stents led to the development of second-generation stents. Multiple trials have demonstrated very low stent thrombosis rates (<1%) with the latter stents. The promise of bioresorbable stents was dimmed by the findings of the ABSORB II trial (Bioresorbable Everolimus-Eluting Scaffold Versus a Metallic Everolimus-Eluting Stent). The findings of the SYNTAX (Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial suggests that the majority of patients with left main stem and three vessel coronary artery disease are better served by coronary artery bypass surgery rather than angioplasty with drug-eluting stents.
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