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).

Care of anticoagulated patients in the acute setting is inconsistent, reflecting the diversity of presentation. As the prevalence of DOAC use will further increase with the aging of the worldwide population, further study and targeted educational efforts are needed to drive more evidence-based care of these patients.

Heart disease is becoming increasingly prevalent globally and becoming a leading cause of mortality. Essential to having healthy organs, blockages are troublesome and that is why for some people, heart stents are an important intervention, but they are not the only thing. Proper medical management along with changes in diets and a sedentary lifestyle along with proper checkups can form a strong shield against heart diseases. This guide provides clear guidelines as to how one can avoid developing these blockages and therefore maintain good circulation of blood in the heart.

Drug-coated balloon (DCB) percutaneous interventional therapy allows for durable reopening of the narrowed lumen via physical tissue expansion and local anti-restenosis drug delivery, providing an alternative to traditional uncoated balloons or a permanent indwelling implant such as a conventional metallic drug-eluting stent. While DCB-based treatment of peripheral arterial disease (PAD) has been incorporated into clinical guidelines, DCB use has been recently curtailed due to reports that showed evidence of increased mortality risk in patients treated with paclitaxel (PTX)-coated balloons. Given the United States Food and Drug Administration's 2019 consequent warning regarding PTX-eluting DCBs and the subsequent marked reduction in clinical DCB use, there is now a critical need to better understand the compositional and mechanical factors underlying DCB efficacy and safety.

Current data demonstrated conflicting long-term safety outcomes in the use of paclitaxel devices in the femoral and/or popliteal arteries, while the role of DCB in BTK disease remains uncertain due to a lack of randomized controlled trial data. In summary, this review provides an overall view of current DCB technologies and progress, followed by an update on DCB clinical data in the treatment of CAD and PAD.

A single-blind randomized trial of the DynamX Coronary Bioadaptor (Elixir Medical, Milpitas, California) found fewer adverse events after 12 months compared with a traditional drug-eluting stent, reported David Erlinge, MD, PhD, head of Cardiology at Skåne University Hospital in Lund, Sweden. In the first 6 months, the stents performed comparably, he said at the Transcatheter Cardiovascular Therapeutics (TCT) 2024 conference.

Debate exists regarding the best terminology for common presentations of heart diseases caused by epicardial and/or microvascular coronary artery disease with or without myocardial ischaemia. In this Comment, we discuss the pros and cons of a new proposal to replace the vessel-based nomenclature of acute and chronic coronary syndromes with the myocardial-oriented nomenclature of acute and non-acute myocardial ischaemic syndromes.

Ultrathin DES were associated with reduced DOCE, TLR and TVR risks in diffuse ISR compared to DEBs.

Local hemodynamic forces are well-known to modulate atherosclerotic evolution, which remains one of the largest cause of death worldwide. Percutaneous coronary interventions with stent implantation restores blood flow to the downstream myocardium and is only limited by stent failure caused by restenosis, stent thrombosis, or neoatherosclerosis. Cumulative evidence has shown that local hemodynamic forces affect restenosis and the platelet activation process, modulating the pathophysiological mechanisms that lead to stent failure.

The burden of coronary in-stent restenosis (ISR) remains a significant clinical challenge. Even with contemporary drug-eluting stent (DES) placement, target lesion revascularization (TLR) occurs at a rate of 2% in the first and in each subsequent year, with TLR occurring after 2 years in nearly half of all patients. Moreover, ≥10% of the patients who experience ISR will go on to develop recurrent ISR, an even more vexing problem. Over the past decade, approximately 10% of all percutaneous coronary interventions in the United States have been for ISR, which has been linked to a greater risk of major adverse cardiac events (MACEs) than have percutaneous coronary interventions for de novo lesions. The mechanisms behind ISR are varied, making its management complex.

The beneficial effect of clopidogrel monotherapy over aspirin monotherapy in patients who underwent percutaneous coronary intervention (PCI) and remained event free for 6-18 months on dual antiplatelet therapy (DAPT) is consistent, regardless of bleeding risk or PCI complexity, according to a post hoc analysis of the HOST-EXAM trial.

When AstraZeneca developed ticagrelor in the mid-to-late 2000s, it needed to demonstrate a clear advantage over clopidogrel (Plavix), then one of the world’s best selling prescription drugs that was nearing patent expiration. The results of PLATO, a 18 624 patient randomised trial conducted across 43 countries, appeared set to actualise those hopes. PLATO investigators, writing in 2009 in the New England Journal of Medicine (NEJM), reported that at 12 months, patients assigned to ticagrelor compared with clopidogrel saw a reduction in risk of the primary endpoint—death from vascular causes, myocardial infarction, or stroke—from 11.7% to 9.8%, a 16% decrease in relative risk.Despite the results, however, the company’s first bid for FDA approval failed. A subgroup analysis found that, in the US, ticagrelor patients had poorer outcomes than those randomised to clopidogrel—a 27% higher risk of the primary endpoint.

Nano/micro-structured wrinkle patterns on nitinol (NiTi) were constructed via laser texturing. Laser-textured NiTi surfaces with micro-W prevented smooth muscle cells (SMC) dedifferentiation and migration. Laser texturing on NiTi stimulated angiogenesis through specific topographical features. Provides insights into stent design and regenerative medicine by bridging in vitro and ex vivo research.

Taking everything into account, the present developments in biomaterials that control macrophages and scavenge ROS for the treatment of inflammatory illnesses have progressed swiftly, presenting a multitude of possible applications for anti-inflammatory biomaterials. The future of anti-inflammatory biomaterials is still radiant despite the fact that many questions remain. We anticipate that this review will provide useful information for the biomedical field and relevant research.

Coronary stents have evolved the treatment of coronary artery disease, with life-saving support from keeping blocked arteries open. These very small devices in the coronary arteries help restore blood flow and prevent chest pain and the possibility of heart attack. Time has passed, and developments in stent technology have evolved into many types of coronary stents, each having its strengths and weaknesses. Among these inventions, one is promising-a biodegradable polymer stent- that dissolves over time after performing its role in artery healing.

These include one-month dual antiplatelet therapy (DAPT) for high bleeding risk (HBR) patients, allowing practitioners to offer personalised, shorter DAPT durations to their patients at high risk of bleeding events, in accordance with the most recent guidelines. Additionally, the Orsiro Mission DES has been approved for calcified lesion treatment, allowing practitioners to target more complex lesions with moderate or severe calcification.