Ticagrelor monotherapy after short-duration DAPT reduces major bleeding complications without compromising cardiovascular protection. This approach offers a promising strategy to optimize outcomes for PCI patients, particularly those at high bleeding risk. Further studies are needed to refine the optimal DAPT duration in various patient populations, especially those with higher ischemic risk.

Although commercially available in numerous countries now for more than a decade, DCB only recently obtained US Food and Drug Administration approval for the treatment of coronary ISR. Moreover, preliminary results from newer generation devices tested in different clinical scenarios have raised the interest of the international community. Accordingly, an up-to-date review is timely particularly with the anticipated wave of research on the matter. Herein, this review encompasses DCB technologies, their worldwide usage, details on relevant indications, and key procedural aspects of DCB angioplasty.

Left atrial appendage occlusion (LAAO) is a well-established alternative to anticoagulation therapy for patients with atrial fibrillation who have a high bleeding risk. After occluder implantation, anticoagulation therapy is still required for at least 45 days until complete LAAO is achieved by neoendocardial coverage of the device. We applied a polylactic acid-resveratrol coating to the LAAO membrane to enhance endothelialization with the goal of shortening the anticoagulation therapy duration.

The cellular and molecular processes that control vascular injury responses after percutaneous coronary intervention involve a complex interplay among vascular cells and progenitor cells that control arterial remodeling, neointimal proliferation, and re-endothelialization. Drug-eluting stents (DES) improve the efficacy of percutaneous coronary intervention by modulating vascular inflammation and preventing neointimal proliferation and restenosis. Although positive effects of DES reduce inflammation and restenosis, negative effects delay re-endothelialization and impair endothelial function.

Two scores widely used to determine whether patients are at high risk for bleeding after coronary stenting disagreed in 22% of patients, and one score underestimated the risk, warned investigators comparing the approaches.

BIOMAG-LL is a prospective, international, multicentre, single arm premarket study that will enrol 100 patients in Europe with de novo coronary artery stenosis and long lesions. Given that the Freesolve RMS is already CE-certified for shorter lesions, the BIOMAG-LL study will evaluate its effectiveness in longer lesions with new device sizes including now 35 mm and 40 mm scaffold lengths to support a broader market release.

The researchers found no difference in the rate of the primary ischemic end point (composite of death, nonprocedural [spontaneous] myocardial infarction, or stroke) between the ticagrelor monotherapy and standard DAPT groups (1.7 versus 2.1 percent; hazard ratio, 0.85; 95 percent confidence interval, 0.63 to 1.16). The ticagrelor monotherapy group had a lower rate of the primary bleeding end point (0.8 versus 2.5 percent; hazard ratio, 0.30; 95 percent confidence interval, 0.21 to 0.45). The findings were consistent across STEMI, NSTEMI, and unstable angina.

The RANGO study is a prospective, single-arm, multicentre, observational, multinational registry. The study included 654 patients enrolled in 16 academic medical centres in Spain and Portugal between June 2017 and July 2018. The primary objective was to evaluate the target lesion failure (TLF) at five years, defined as cardiac death, myocardial infarction (MI) not clearly attributable to a non-intervention vessel, and clinically driven target lesion revascularisation (TLR). Secondary objectives included target vessel failure (TVF), patient-oriented composite endpoint (PoCE), and stent thrombosis.

The acquired business is rooted in robust research and development, clinical expertise, and global manufacturing capabilities, which we believe will further bolster Teleflex’s innovation pipeline, and position the company to participate in the emerging potential for resorbable scaffold technologies. We believe the acquired business will be a meaningful contributor to our growth in the coming years, diversify our geographic revenue mix with 50% of the acquired revenues generated in Europe, the Middle East and Africa, and provide additional scale for investment into innovation.”

Despite inconsistent study results, the superiority of BVSs over DESs has not been demonstrated in randomized trials, and DES devices continue to be the preferred choice for most cases of arterial disease. Esprit BTK (Abbott Vascular) received approval from the US FDA for below-knee lesions in 2024, offering hope for the use of BVSs in other vascular conditions. Enhancing the design and thickness of BVS scaffolds may open up new possibilities. Large-scale and longer-term comparative studies are still required.

Percutaneous coronary intervention (PCI) for thrombotic and heavily calcified coronary artery lesions and occlusions is often hampered by difficulty in wiring the occlusions, restoring antegrade flow, and proceeding to successful stent implantation. Characterization of dynamic anatomical features such as thrombi and the calcium distribution is key to prevent periprocedural complications and long-term adverse events, which are mainly driven by stent underexpansion and malapposition and may prompt in-stent restenosis or stent thrombosis. Therefore, multimodal imaging is a critical step during PCI to better characterize these high-risk lesions and select those in which careful preparation with debulking devices is needed or to guide stent optimization with the aim of improving procedural and long-term clinical outcomes.

The Prevail DCB is intended to be used during percutaneous coronary intervention (PCI) procedures to treat narrowed or blocked coronary arteries in patients with coronary artery disease. During the catheter-based procedure, the balloon inflates within the artery, while the drug (paclitaxel) is delivered to the arterial tissue where it is absorbed and retained to provide an anti-restenotic effect.

In patients with AMI complicated by cardiogenic shock, the use of potent P2Y12 inhibitors was associated with a lower risk of MACE compared with clopidogrel, without an increased risk of BARC type 2 or greater bleeding. The current data supports the use of potent P2Y12 inhibitors in patients with AMI and cardiogenic shock, except in patients aged ≥ 75 years or receiving VA-ECMO support.

The study showed that PRECISE-DAPT underestimated the risk for bleeding across almost all scores. ARC-HBR is not as specific, yielding a simple yes or no answer to whether the patient is at high risk. “The claims that they make are quite different. The bar is higher for PRECISE-DAPT to say it does what it aims to do,” said Lim. A major issue is that the risk estimated by a score must correspond to the risk observed in the patient population, called “calibration.” In this study, PRECISE-DAPT misestimated the risk, Lim and Ueda reported.

This randomized controlled trial directly compared the outcomes of two paclitaxel-coated balloons using different excipients: Genoss DCB using shellac plus vitamin E as an excipient vs. IN.PACT Admiral using urea. Genoss DCB was non-inferior to IN.PACT Admiral regarding 6-month late lumen loss evaluated on CT angiography. Both DCBs showed no significant differences in clinically driven target lesion revascularization, major amputation, and all-cause mortality.

Endovascular treatment (EVT) for vertebrobasilar artery occlusion (VBAO) with atrial fibrillation presents complex clinical challenges. While 45.1% achieved favorable outcomes at 90 days, our advanced machine learning approach unveiled subtle interaction effects among clinical variables not captured by traditional statistical methods. The predictive model distinguished high-risk subgroups by integrating multiple parameters, demonstrating superior prognostic precision compared to standard NIHSS-based assessments. Novel findings include nonlinear relationships between dyslipidemia, stroke severity, and functional recovery. The developed predictive algorithm (AUC 0.719 internally, 0.684 externally) offers a more sophisticated risk stratification tool, potentially guiding personalized treatment strategies in high-complexity VBAO patients with atrial fibrillation.

CAAs and CAEs are localized dilations in the coronary arteries that may present as fatal acute coronary syndrome. Current literature regarding the genetic basis for CAA and CAE development is lacking. To the best of our knowledge, this report serves as the first to make an association between a variant in the COL3A1 gene, which encodes the structural component of type III collagen, and the development of coronary artery aneurysms.

Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor exists as the standard post-percutaneous coronary intervention (PCI) with drug-eluting stents (DES), but the optimal duration remains ambiguous due to the competing risks of ischemic events and bleeding.

HCR is purported to offer a “best of both worlds” approach to coronary revascularisation in of multivessel coronary artery disease. Benefits include the minimal access nature of MIDCAB, avoiding cardiopulmonary bypass, long-term prognostic benefit of LIMA to LAD bypass and improved performance of newer generation drug-eluting stents compared to venous conduits. Carefully chosen patients by a heart team stand to benefit from HCR, although evidence is limited and large-scale RCTs have yet to prove the superiority of HCR versus CABG or PCI.

Dual antiplatelet therapy (DAPT), which combines aspirin and a P2Y12 receptor inhibitor, is commonly recommended after percutaneous coronary intervention (PCI) to prevent ischemic events and complications related to stents. However, the benefits of prolonged DAPT may be outweighed by an increased risk of bleeding, which has a negative impact on prognosis. Various strategies have been explored to mitigate this risk, including de-escalating DAPT by discontinuing 1 of the antiplatelet agents. Shortening the duration of DAPT has been shown to effectively reduce bleeding rates, which is particularly important for patients at high bleeding risk (HBR), including those who require long-term oral anticoagulation (OAC).