Revascularization strategies for patients with established chronic coronary syndrome

Abstract

Coronary artery disease is the most common type of cardiovascular disease, leading to high mortality rates worldwide. Although the vast majority can be treated effectively and safely by medical therapy, revascularization strategies remain essential for numerous patients. Outcomes of both percutaneous coronary intervention and coronary artery bypass grafting improve in a rapid pace, resulting from technical innovation and ongoing research. Progress has been achieved by technical improvements in coronary stents, optimal coronary target and graft selection, and the availability of minimally invasive surgical strategies. Besides technical progress, evidence‐based patient‐tailored decision‐making by the Heart Team is the basic precondition for optimal outcome. The combination of fast innovation and long‐term clinical evaluations creates a dynamic field. Research outcomes should be carefully interpreted according to the techniques used and the trial's design. Therefore, more and more trial outcomes suggest that revascularization strategies should be tailored towards the specific patient. Although the European Society of Cardiology/European Association for Cardio‐Thoracic Surgery guidelines on myocardial revascularization date from 2018 and a large variety of trial outcomes on revascularization strategies in chronic coronary syndrome have been published since, we aim to provide an updated overview within this review.

Usability, safety, efficacy, positioning of the Atlas drug-eluting coronary stent: Evaluation of preliminary perioperative results

“…Minimally invasive techniques are the preferred treatment modality for revascularization in CAD 2,3 .…”

“…Coronary artery bypass grafting (CABG), which is more invasive than percutaneous coronary intervention (PCI), was the only revascularization therapy prior to the introduction of PCI in 1977 3 . However, CABG is even superior in certain patient groups, and minimally invasive techniques have become the preferred method for revascularization in recent decades.…”

“…However, CABG is even superior in certain patient groups, and minimally invasive techniques have become the preferred method for revascularization in recent decades. Because the survival rate of patients with CAD has increased with PCI [2][3][4][5] . On the other hand, reocclusion after PCI has been a signi cant problem 6,7 .…”

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence

“…Revascularization is indicated in patients who receive medical treatment as per the ESC/EACTS guidelines [7] but still have persistent symptoms and in patients in whom there is a possibility of improvement in prognosis. Several studies prove that revascularization is more effective in improving symptoms of ACS and enhancing quality of life as compared to medical therapy alone [16]. This section sheds light on various revascularization modalities.…”

Atlas drug-eluting coronary stents inhibits neointimal hyperplasia in sheep modeling

“…Since the second half of the 20th century, minimally invasive techniques have revolutionized the field of interventional cardiology. Although more invasive CABG is superior in some groups of patients, they have become the preferred methods of revascularization (4)(5)(6). On the other hand, reocclusion of the coronary arteries due to thrombotic occlusion in acute stages or neointimal hyperplasia (NIH) in the longer periods following minimally invasive techniques has been a major problem after MIT, particularly after bare metal stents (BMS) (7)(8)(9).…”