Key result
Percutaneous coronary interventions outnumber bypass surgery by a factor of 2 to 4, with stenting as the default approach despite improving balloon angioplasty results in only about 25% of cases.
A critical appraisal of the current state and future directions of interventional cardiology, highlighting the dominance of stenting and emerging procedures like PFO closure and TAVR.
Stenting dominates PCI despite limited gains over balloon angioplasty; leaves open comparative trials versus bypass amid emerging interventions.
After 75 years of invasive and over 50 years of interventional cardiology, cardiac catheter-based procedures have become the most frequently used interventions of modern medicine. Patients undergoing a percutaneous coronary intervention (PCI) outnumber those with coronary artery bypass surgery by a factor of 2 to 4. The default approach to PCI is the implantation of a (drug-eluting) stent, in spite of the fact that it improves the results of balloon angioplasty only in about 25% of cases. The dominance of stenting over conservative therapy or balloon angioplasty on one hand and bypass surgery on the other hand is a flagrant example of how medical research is digested an applied in real life. Apart from electrophysiological interventions, closure ot the patent foramen ovale and percutaneous replacement of the aortic valve in the elderly have the potential of becoming daily routine procedures in catheterization laboratories around the world. Stem cell regeneration of vessels or heart muscle, on the other hand, may remain a dream never to come true.
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Bernhard Meier (2006) conducted a review in Coronary artery disease / Structural heart disease. Interventional cardiology procedures was evaluated. Percutaneous coronary interventions outnumber bypass surgery by a factor of 2 to 4, with stenting as the default approach despite improving balloon angioplasty results in only about 25% of cases.
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