Late residual stenosis, defined histologically as the difference between the luminal areas of a proximal reference site and lesion site normalized by the luminal area of the reference site, was 52±32%. Histological indices of chronic constriction, neointimal-medial growth, and adventitial growth were defined on the basis of the areas of these arterial wall layers at the lesion site relative to the reference site. Another parameter defined as the ratio of adventitial area to the area of intima+media at the lesion site allowed evaluation of the relative importance of these layers. Surprisingly, late residual stenosis correlated with chronic constriction (P=.0003) but not with neointimal-medial growth or adventitial growth. The ratio of adventitial area to the area of intima+media at the lesion site also correlated with chronic constriction (P=.01). These findings suggest that factors related to arterial remodeling rather than neointimal-medial growth may dominate the response to angioplasty.

This study demonstrates the involvement of the adventitia in the vascular repair process after medial injury. The hypercellularity of the adventitial layer, proliferation of fibroblasts, and modulation of their phenotype to myofibroblasts are associated with the development of the thickened adventitia. It is postulated that these phenomena affect vascular remodeling and may provide an important insight into the mechanisms of vascular disorders.

This study demonstrates translocation of adventitial fibroblasts to neointima, their phenotypic modulation to myofibroblasts, and distinct characteristics of myofibroblasts within neointima after severe endoluminal coronary injury. These findings suggest the significance of vascular fibroblasts in the process of arterial repair.

Restenosis appears to be determined primarily by the direction and magnitude of vessel wall remodeling (ΔEEM). An increase in EEM is adaptive, whereas a decrease in EEM contributes to restenosis.

In the ABSORB II trial, BVS use showed frequent dynamic vessel remodeling with larger increase in mean lumen and vessel area than the comparator DES. This vessel remodeling was determined by patient baseline characteristics and periprocedural factors including balloon-artery ratio and expansion index. The clinical effect of this observed lumen and vessel remodeling requires investigation in further large clinical studies.

Percutaneous coronary intervention plays an important role in the management of both acute and chronic coronary syndrome. Despite advances in stent technology, in-stent restenosis remains a major Achilles heel in percutaneous coronary intervention and can confer high risk of adverse outcomes for patients. We describe a novel technique (the double-DCB technique) for the treatment of recurrent in-stent restenosis by applying 2 different drug-coated balloons, thereby avoiding the implantation of another layer of metal in our patients. More studies are required to understand the long-term outcomes of this technique and compare it with other treatment modalities in a randomized setting.

Coronary artery calcification (CAC) represents a clear sign of advanced atherosclerosis and a strong indicator of coronary artery disease burden and cardiovascular risk. Beyond its established prognostic value, CAC significantly influences plaque biology, lesion morphology, and the technical complexity of percutaneous coronary intervention (PCI). This review summarizes current knowledge on the mechanisms of vascular calcification, its clinical determinants, diagnostic assessment, and therapeutic implications. Vascular calcification is now understood as an active, regulated process involving osteogenic transdifferentiation of vascular smooth muscle cells, inflammatory signaling pathways, extracellular vesicle release, and disturbances in mineral metabolism. Distinct calcification phenotypes exert different effects on plaque stability: micro- and spotty calcifications are frequently linked to plaque vulnerability, whereas dense, sheet-like calcification is more typical of stable fibrocalcific lesions.

Despite a more complex lesion profile in RMS, no statistically significant differences in 1-year clinical outcomes were observed between the two registries. This analysis is hypothesis-generating though not conclusive. Conclusive analysis can only be provided by a randomized controlled trial.

While multiple studies have demonstrated the safety of DCB, the optimal duration and type of antiplatelet therapy following DCB treatment remain unclear. The decision on the optimal duration and type of antiplatelet drugs after DCB treatment should depend on the clinical and angiographic characteristics of each patient. DCB may offer several advantages over DES, including a shorter duration of DAPT or the possibility of using a SAPT in selected cases, which carries a lower risk of bleeding, particularly in high-risk patients.

Despite improvements in stent platform technology, in-stent restenosis (ISR) remains a significant clinical concern. There are several potential strategies for treatment of ISR including implantation of further drug-eluting stents which provides good clinical and angiographic results, and the use of drug-eluting balloons which deliver antiproliferative therapy whilst avoiding the addition of a further layer of stent in the vessel(1).

Though angiographic outcomes are slightly worse with drug-coated balloons, experts agree that they’ll continue to have a clinical role.

Drug-coated balloons (DCB) provide a “leave-nothing-behind” strategy for the treatment of ISR, with the potential to preserve vascular vasomotor function and reduce the risk of late adverse events in complex lesions, including ISR; however data regarding DCB performance remain inconsistent.2,3 The clinical efficacy profile of DCB angioplasty is critically dependent on optimal lesion preparation.4 Specialty balloons, including cutting and scoring balloons, may facilitate more effective acute neointimal modification, enhance drug uptake and retention, and reduce residual stenosis and acute recoil.5 Nevertheless, real-world comparative data evaluating specialty balloon-based vs conventional balloon-based lesion preparation strategies (semi-compliant and non-compliant balloons) prior to DCB angioplasty in ISR remain limited.

Drug-coated balloon (DCB) treatment is an emerging strategy for de novo coronary artery disease (CAD), but procedural optimization remains uncertain. This study analyzed 317 patients who underwent DCB-based intervention for de novo CAD and angiographic follow-up: SR (successful, stent-like result: diameter stenosis < 20% at follow-up angiography, n = 84, 93 lesions) and Non-SR (n = 224, 358 lesions) groups. Baseline clinical and lesion characteristics were similar, except that SR lesions had larger diameter. In SR lesions, specialty balloons were more frequently utilized (p = 0.025), and maximal balloon diameter and balloon-to-artery ratio were significantly greater compared to Non-SR lesions (p < 0.001 and p = 0.008). At a median 8-month follow-up, SR lesions exhibited larger minimal luminal diameter (MLD) and lower late lumen loss, with negative values indicating positive vessel remodeling.

This research article examines the one-year clinical outcomes of bioresorbable magnesium scaffolds in cardiovascular interventions. The study evaluates the efficacy and safety profile of this innovative technology, which offers the advantage of gradual absorption within the body, eliminating the need for permanent implants. The findings provide critical data on patient outcomes, vessel patency rates, and adverse events following the use of magnesium-based devices. This investigation contributes valuable insights to interventional cardiology, demonstrating the potential of bioresorbable scaffolds as a promising alternative to conventional metallic stents in coronary artery disease treatment.

Results: Across published studies, DCBs have shown outcomes that are non-inferior to those of DES in selected ACS subsets, together with a lower risk of major ...

... meta-analyses published between 2020 and 2025. The analysis focuses on comparative safety and efficacy across major indications: in-stent restenosis (ISR) ...

The Graduate School of Cardiovascular & Blood Sciences offers multidisciplinary training for and through cardiovascular research and integrates all levels of research: from the fundamental approach to the last clinical development in the cardiovascular field.

The Osaka Prognostic Score (OPS) has demonstrated prognostic value in various cardiovascular settings. However, its role in predicting long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) remains insufficiently explored. This study aimed to investigate the association between baseline OPS and one-year all-cause mortality in patients presenting with STEMI.

Acute coronary syndrome (ACS) encompasses a spectrum of ischemic cardiac conditions associated with significant global morbidity and mortality, commonly driven by atherosclerotic plaque disruption and thrombosis, and remains a major clinical challenge despite advances in cardiovascular care. Persistent variability in early diagnosis, risk stratification, and the integration of emerging therapies into routine practice highlights existing gaps in translating evolving evidence into consistently improved clinical outcomes. This narrative clinical review aims to synthesise recent advances in diagnostic approaches and therapeutic strategies, focusing on biomarkers, imaging modalities, pharmacological interventions, and precision-based management. 

Three-dimensional bioprinting of hydrogels represents a transformative approach in tissue engineering, enabling fabrication of precisely engineered scaffolds with customizable architectures and biomimetic properties. This comprehensive review examines two decades of advances in hydrogel-based bioprinting technologies, including light-based, extrusion-based, and inkjet-based systems, evaluating their respective capabilities in printing resolution, structural integrity, and cell compatibility. The analysis encompasses both natural and synthetic hydrogels, exploring their complementary advantages in bioactivity and mechanical performance. Recent developments in tough and composite hydrogels are highlighted, demonstrating significant progress toward clinically viable tissue engineering solutions that bridge the gap between biological functionality and engineering precision.