Aging is a complex biological process leading to functional decline and disease susceptibility. This article proposes that chronic activation of tissue damage response mechanisms drives aging, with aged organs exhibiting features similar to those seen after acute injury, such as histolysis, inflammation, immune cell infiltration, accumulation of lipid droplets, and induction of cellular senescence. The overlap between injury and aging phenotypes is supported by evidence that interventions slowing aging often impair healing, and vice versa. This perspective offers a unifying framework to understand aging and suggests new directions for treating age-related diseases, cancer, and the aging process.

Teleflex has unveiled four-year follow-up data from the BIOMAG-I clinical trial, demonstrating the favorable long-term safety profile of the Freesolve third-generation resorbable magnesium scaffold. The multicenter European study enrolled 116 patients and observed no cardiac-related events between years two and four, including no cardiac deaths, target-vessel myocardial infarctions, or scaffold thrombosis. The target lesion failure rate remained at 3.5%, with minimal clinically-driven revascularization requirements. These results support the scaffold's efficacy as a temporary mechanical support device that maintains excellent safety outcomes while allowing complete vascular healing, representing a promising advancement in interventional cardiology.

An individual patient data meta-analysis of long-term data from four major trials comparing percutaneous coronary intervention (PCI) to coronary artery bypass graft (CABG) surgery among patients with left main coronary artery disease has shown no significant differences in mortality over 10 years with the two revascularisation approaches.

Sitting down in the CX Studio after presenting the results for the first time in Europe at CX 2026, Barco explains the thought process behind the “unique” SirPAD trial design, how the primary outcome of major adverse limb events (MALE) occurred in 8.8% of patients enrolled in the sirolimus-coated balloon group compared to 15% in the uncoated balloon group at one year, and how there was a statistically significant reduction in the composite key secondary endpoint of any unplanned target limb amputation or target limb revascularisation.

Endothelial cells in BP-SES demonstrated a significantly greater number of tight junctions than those in DP-EES according to by transmission electron microscopy for both days (p<0.05). Various parameters, including an inflammatory reaction and neointimal formation, were comparable among the groups at 7 and 10 days. An abluminal biodegradable polymer-coated SES showed the least fibrin deposition and greatest endothelial cell recovery at an early stage following implantation in the coronary arteries of mini-pigs.

Antiplatelet therapy represents the cornerstone of treatment for the prevention of local and systemic ischaemic complications in patients with CAD undergoing PCI. Over the past decades different antiplatelet regimens using aspirin and P2Y12 inhibitors have been developed and implemented in clinical practice. A better understanding of the ischaemic and bleeding risk profile, as well as individual responsiveness to antiplatelet agents, has been instrumental in defining the optimal regimen for the individual patient. In particular, the intensity and the duration of aspirin and P2Y12 inhibiting therapy should be adjusted to reduce the risk of ischaemic complications while minimising the risk of bleeding. Strategies developed to mitigate the risk of bleeding include shortening DAPT duration, P2Y12 inhibitor monotherapy and de-escalation. In the absence of high bleeding risk, patients at increased ischaemic risk may consider prolonging intensified antithrombotic therapy either by means of DAPT or DPI. The use of platelet function and genetic testing can indeed be of aid in the selection of P2Y12 inhibitor therapy. An integrated approach, including scores/definitions to define ischaemic and bleeding risk, procedural characteristics, and tools to help assess drug response, represents the most promising approach for a personalised selection of antiplatelet agents among patients undergoing PCI.

Macrophages, as central orchestrators of tissue homeostasis, exhibit remarkable developmental and functional plasticity across diverse physiological and pathological contexts. Mechanistically, microenvironmental cues govern phenotypic switching, while dysregulated crosstalk with stromal cells drives fibrosis and chronic inflammation. Emerging therapeutic strategies targeting macrophages demonstrate potential in restoring tissue homeostasis. However, challenges persist in achieving spatiotemporal precision and balancing pro-repair versus pro-fibrotic outcomes. This review synthesizes current understanding of macrophage biology, encompassing their developmental origins, phenotypic heterogeneity in tissue-specific niches, and multifaceted roles in extracellular matrix (ECM) remodeling, immune surveillance, and organ homeostasis. A comprehensive view of the macrophage regulatory landscape highlights that precise spatiotemporal regulation serves as the cornerstone for macrophages to restore tissue homeostasis.

As a new generation of biomaterials, biodegradable zinc (Zn)-based implants hold substantial promise for clinical use due to their favorable biocompatibility and controllable degradation behavior. This review summarizes recent progress in Zn-based implants, focusing on the physiological roles of Zn, current Zn-based implant systems, and relevant applicable standards. To address the critical challenges faced in practical applications, such as optimizing corrosion rate, antibacterial performance, and biocompatibility, researchers have employed innovative strategies, including alloying (e.g., Zn-Mg, Zn-Mn, Zn-Li), surface modifications, and functional coatings. Meanwhile, a detailed overview is provided of in vitro and in vivo degradation evaluation systems, advances in preclinical animal studies, and the status of clinical trials, together with regulatory requirements for biodegradable metals set by domestic and international authorities. Key mechanistic and translational bottlenecks that currently limit clinical adoption are identified, together with critical directions for the rational design and standardized evaluation of next-generation Zn-based implants.  

Ureteral stents are fundamental devices in urology but currently used stents are associated with adverse events such as encrustation and infections. Biodegradable magnesium yttrium (Mg-Y) has shown potential as base material for a next-generation biodegradable ureteral stent due to reported lower corrosion rates than pure Mg, homogeneous corrosion and associated antibacterial activity. In the present work, meshed tubes were produced via additive manufacturing (AM) and extruded, and coiled, wire tubes were fabricated. The corrosion behavior in dynamic conditions was studied, as well as the cytotoxicity and antibacterial activity. AM samples showed faster corrosion (associated with higher surface area and impurity level), while the extruded ones showed some localized corrosion points. Additionally, AM samples demonstrated lower toxicity compared with the extruded-coiled ones to urinary tract derived cell lines, at a low metal exposed surface area/volume ratio of 27.5 mm2/ml. AM samples also showed antibacterial activity against E. coli. This study highlights the potential of Mg-Y for the development of a biodegradable ureteral stent, an innovative concept with expected improved patient outcomes.

Although cardiovascular implants encompass diverse device categories and clinical applications, their evolution has been driven by a common set of biological, engineering, and translational challenges. Across stents, heart valves, vascular grafts, cardiac patches, and implantable bioelectronic systems, the field has progressively transitioned from passive structural replacements toward biologically interactive, regenerative, and increasingly intelligent therapeutic platforms. This evolution reflects a growing recognition that long-term clinical success depends not only on restoring anatomy or hemodynamic function, but also on achieving durable integration with the dynamic cardiovascular microenvironment.

ISR remains a clinically relevant and mechanistically heterogeneous complication of coronary stenting, occurring across a spectrum from focal underexpansion to diffuse neoatherosclerosis and multilayer recurrent disease. Its management requires a substrate-first approach: identifying the dominant mechanism with intracoronary imaging before selecting lesion preparation strategy and definitive therapy. Intracoronary imaging with IVUS or OCT is central to this approach and is supported by current international guidelines, though the evidence base is predominantly observational, and routine use must be balanced against local expertise, cost, and patient-level factors including contrast load. Coronary angiography with physiological assessment remains the initial diagnostic step, and imaging is most valuable when the mechanism of ISR is not angiographically apparent.

Graphene-coated coronary stents demonstrated favorable vascular compatibility and mid-term safety in a clinically relevant swine coronary artery model. Multimodal assessment using QCA, OCT, and cryogenic scanning electron microscopy confirmed stable vascular integration without evidence of thrombosis, excessive restenosis, systemic toxicity, or adverse vascular remodeling. The vascular response observed for graphene-coated stents was comparable to that of commercially available drug-eluting stents, while imaging findings suggested a tendency toward enhanced tissue coverage and favorable healing characteristics. These results support the feasibility of graphene-based surface modification for coronary stents and justify further long-term preclinical studies incorporating histopathological and molecular evaluation of endothelialization and inflammatory responses.

Even under extreme mechanical stress known to delay endothelial recovery, the CD31-coated stent preserved lumen geometry and flow comparable to a DES while achieving complete endothelial coverage without drug release. Higher minimum stent and mean lumen areas suggest maintained expansion and limited neointimal growth despite the absence of antiproliferative drug. These findings indicate that the CD31 coating preserves mechanical integrity and vascular compatibility even in a stringent injury model, warranting further evaluation under standard implantation (BAR ≈ 1.05) and high-bleeding-risk conditions. By promoting rapid vascular healing without an antiproliferative agent, this biomimetic approach may represent a path toward safer DAPT de-escalation in interventional cardiology.

In patients with ACS undergoing PCI, short DAPT followed by P2Y12 inhibitor monotherapy is superior to standard DAPT with respect to NACE. Although a brief period of DAPT appears warranted after ACS, the optimal timing of aspirin discontinuation remains uncertain. While earlier aspirin discontinuation may be associated with greater net clinical benefit owing to reduced bleeding, 3-month DAPT may be associated with more favourable ischaemic outcomes, underscoring the importance of individualising DAPT duration according to bleeding and ischaemic risk.

While stents are a vital part of cardiac care, they can also carry risks. A new study conducted by Dr. Mladen Vidovich with the University of Illinois, Chicago found the company’s device, the DynamX Coronary Bioadaptor System, can address localized rigidity due to the implant. Rigidity or “caging” is common after traditional stent placement and is thought to lead to continuing cardiac risk. Elixir’s drug-eluting implant can potentially restore near-natural vessel movement.

Uremic toxins may worsen endothelial injury by disrupting intercellular connections, highlighting the complex pathogenic environment in CKD. Given these insights, the need for standardized diagnostic thresholds for endothelial dysfunction in geriatric CKD patients is clear. Serum sVE-cadherin emerges as a promising novel biomarker for assessing endothelial health, offering potential for earlier intervention and improved cardiovascular outcomes. It may be a potent indicator of endothelial dysfunction and should be featured in future studies of elderly CKD patients.

In this paper, we have developed and computationally evaluated an AI-augmented Digital Twin framework designed to correlate the modeled degradation process with new bone formation. Based on a stochastic approach, it was demonstrated that the major risks associated with Mg-based alloy degradation, such as hydrogen emission and the cytotoxicity of Mg2+ ions at certain concentrations, could be theoretically managed within the modeled bounds.It was concluded that the Mg-Zn alloy exhibited favorable simulated behavior, with a computed protection efficiency of 92.97%, indicating a high probability of suppression of hydrogen gas evolution under the selected boundary assumptions. In addition, a synchronization index greater than 1, as within the model’s logic, indicates that bone regeneration replaces implant degradation.

DCBs represent a safe and effective option for selected patients with ACS. They provide anti-restenotic efficacy comparable to DES across multiple ACS subsets, with the additional advantages of shorter DAPT requirements, preservation of native vessel integrity, and avoidance of permanent metallic implant complications. They are particularly well suited to high-bleeding-risk patients, ACS occurring in small vessels or at sites of in-stent restenosis, and selected complex lesion morphologies. Limitations include the need for meticulous lesion preparation and operator experience, the relative scarcity of long-term and hard-endpoint data, and the absence of dedicated outcomes evidence for AI- and robotics-assisted DCB delivery. Adequately powered randomized trials with longer follow-up—together with the awaited results of TRANSFORM II, REC-CAGEFREE II, and other ongoing studies—should help define the place of DCBs alongside DES in routine ACS care.

Intracoronary drug delivery balloon procedures represent a specialized interventional cardiology technique designed to deliver therapeutic agents directly to coronary arterial lesions. This approach enables targeted medication administration with enhanced efficacy while minimizing systemic exposure and associated side effects. The procedure involves advancing a specialized balloon catheter to the site of coronary stenosis, where pharmaceutical agents are released locally. This method is particularly valuable for preventing restenosis, reducing inflammation, and improving long-term clinical outcomes in patients undergoing percutaneous coronary intervention. The technology demonstrates significant potential in advancing personalized cardiovascular treatment strategies and optimizing therapeutic delivery mechanisms in coronary artery disease management.

This systematic review and meta-analysis compared sirolimus-coated balloons (SCBs) and paclitaxel-coated balloons (PCBs) for treating coronary artery lesions, including de novo lesions and in-stent restenosis. Analyzing ten studies comprising 5,246 patients, researchers found no significant differences between the two drug-coated balloon types across safety outcomes such as all-cause mortality, cardiac death, and myocardial infarction. Similarly, efficacy measures including target lesion failure, target lesion revascularization, major adverse cardiac events, and binary restenosis showed equivalent results. The findings indicate that neither SCBs nor PCBs demonstrate clinical superiority, suggesting that device selection should be determined by specific lesion characteristics and individual patient clinical context rather than inherent differences between the technologies.