Welcome to Interventional Cardiology – Volume 7 Issue 1. The pace of change in the interventional sphere continues unabated, with a plethora of study data, trial results and breaking news frequently challenging the boundaries of our knowledge. Progress over the last ten years has indeed been great. For us, as practicing physicians, there are in place great structures of learning and support, with a number of high-impact journals, excellent educational activities of dedicated professional associations, and industry-leading events all making valuable contributions to our personal growth. Yet, despite this, staying best informed on a broad spectrum of issues can remain a challenge. How can we remain informed of best practice, not just in our own core area of interest but also across the entire panorama of the field?
This is where Interventional Cardiology hopes to make a contribution. This issue, like those that have gone before, comprises carefully selected reviews that seek to update the time-pressured physician on some of the most pertinent developments affecting everyday clinical practice.
In this issue, Nicolas Foin and colleagues note that stent strut malapposition, which, it is suggested, increases the risk of stent thrombosis, remains frequent in bifurcation even after recommended final kissing balloon inflation. The authors suggest that the introduction of dedicated designs represents an interesting potential for overcoming the limitations of conventional devices, and call for randomised trials to validate their benefits and popularise their routine use. In their article, ‘Early Stent Thrombosis after Percutaneous Coronary Intervention for Acute Myocardial Infarction,’ Georgios J Vlachojannis, Bimmer E Claessen and George D Dangas discuss the most feared complication of coronary stent treatment. Emerging data suggest that primary percutaneous coronary intervention for ST elevation myocardial infarction (STEMI) can be a predictor of subsequent stent thrombosis. The authors suggest that since patients presenting with STEMI are at increased risk of ST, employment of the optimal pharmacological, procedure- and device-related prevention and treatment modalities are imperative.
In risk stratification, Philippe Généreux et al. note that despite some concerns about its reproducibility between cardiologists and its power of discrimination, the SYNTAX score remains the most powerful angiographic tool to predict events after percutaneous coronary intervention. The authors stress that knowledge and mastering of the score definitions remains of paramount importance in adequate stratification, whilst exploring the variables with the highest interobserver variability.
Elsewhere, in infrapopliteal endovascular therapy, Gary M Ansel and Peter A Schneider report that despite advances in below-the-knee angioplasty balloons and a focus on angioplasty technique, current percutaneous angioplasty results demonstrate one-year restenosis rates up to 80 %, depending on lesion complexity. The authors report that drug-coated balloons have demonstrated superior patency in the superficial femoral artery and it is yet to be determined if this technology can achieve improved patency and the clinical outcomes in the infrapopliteal region.
Spatial constraints deny us the opportunity to list the many other valuable contributions enclosed within. We hope that within your busy schedule you may find a few moments to enjoy them.