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A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography Low shear stress induces vascular eNOS uncoupling via autophagy-mediated eNOS phosphorylation Contemporary prevalence of pulmonary arterial hypertension in adult congenital heart disease following the updated clinical classification Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease Radial versus femoral artery access in patients undergoing PCI for left main coronary artery disease: analysis from the EXCEL trial Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis. The PRECOMBAT-2 (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease) study Definition and Management of Segmental Pulmonary Hypertension Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents-Cardiogroup III Study) Outcomes of procedural complications in transfemoral transcatheter aortic valve replacement Pulmonary hypertension related to congenital heart disease: a call for action

Review Article2019 May 10. doi: 10.1097/HCO.0000000000000638.

JOURNAL:Curr Opin Cardiol. Article Link

Major trials in coronary intervention from 2018

Patel A, Marah N, Balan P et al. Keywords: lesion assessment, novel stent design, acute coronary syndromes; chronic total occlusion intervention

ABSTRACT

PURPOSE OF REVIEWThis article will review the major clinical trials related to coronary intervention that were released in 2018. Areas of interest include lesion assessment, novel stent design, acute coronary syndromes (ACSs), and major breakthroughs in chronic total occlusion interventions.


RECENT FINDINGS -  The benefit of intracoronary imaging and hemodynamic assessment was demonstrated by multiple studies, which found improved procedural and clinical outcomes in patients who underwent advanced assessment of intracoronary lesions. The optimal use of drug-coated balloons in coronary disease still remains unclear with conflicting data regarding the benefit of DCB over everolimus-eluting stents for the treatment of in-stent restenosis. Trials in bioresorbable scaffolds also saw a high level of interest after the ABSORB IV trial showed promising results with changes in implantation technique. Multiple studies evaluated complete revascularization versus infarct-related only revascularization in patients with ACS; however, data was conflicting in regard to what is the best strategy. Lastly, the EUROCTO study was released in 2018 and was the first trial to show symptomatic benefit of revascularization of chronic total occlusions.


SUMMARY -  The ESC/EACTS guidelines on complete versus partial revascularization, treatment of in-stent restenosis, and revascularization during cardiogenic shock were updated to reflect data obtained from trials released in 2018.