Introduction
LITVACK, FRANK
1995-08-01 00:00:00
UCLA Schoul of Medic ine, Lus Angeles, Callfur nia The current issue of the Journal of Interventional Cardiology is devoted to exploring the link between interventional cardiology and new concepts in the molecular approach to coronary artery disease. Interventional coronary technologies have. over the past decade, advanced at a prodigious pace. Using any or a combination of the currently available interventional devices, there are few lesions which can no longer be acutely recanalized with relative safety. These therapeutic advances, however, have been largely mechanical and reprebent a triumph of clinical research and biomedical engineering. Penistent problems remain with restenosis, thrombosis, and disease progression. It is likely that many of our newer therapeutic agents will be redesigned based on an improved understanding of the biology of vascular disease. The newest class of agents, the IIb/IIIa blocking drugs, clearly emanate from a major discovery in basic science related to the discovery of the IIb/IIIa receptor. Improved understanding of the biology of arterial thrombosis will likely result in further additions to our pharmacological armamentarium. Beyond this, understanding the vascular response to injury at the most elemental level-gene expression-will allow scientists and the pharmaceutical industry to conceive of, develop, and Address for reprints: Frank Litvack, M.D., Cardiovascular Intervention Center. P.O. Box 48750, Los Angeles, CA 90048-0750. Fa: (310) 967-0106. test a broad variety of newer therapeutic agents, including oligonucleotide and gene therapy. Subject matter that just a few years ago appeared lofty and of limited direct relevance to the interventionalist has now assumed more practical importance. As such, the next generation of interventional cardiologists will need a good working knowledge of the biology of the diseases they treat. This issue of the Journal is designed to provide an introduction as well as an overview of the important advances in basic science which are relevant in interventional cardiology. By the end of this decade, the multidevice, lesion specific approach to coronary recanalization should allow for minimally invasive treatment of even the most complex coronary lesions. New devices for recanalization of chronic total occlusions, improved stent technology and a better understanding of the role of “debulking†are just around the corner. Parallel developments with respect to novel bioengineered pharmaceuticals should provide effective adjunctive therapy with respect to restenosis, thrombosis, and possibly vascular remodeling. When these two disciplines-the mechanical and the biological-finally merge, minimally invasive therapy for the vast majority of patients with symptomatic coronary disease will become a cost-effective and safe reality. This should be achieved within the first decade of the next century and is likely to make coronary artery bypass surgery a relic of the 20th century. Vol. 8. No. 4. 1995 Journal of Interventional Cardiology
http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.pngJournal of Interventional CardiologyWileyhttp://www.deepdyve.com/lp/wiley/introduction-uVOD2FD3GB
UCLA Schoul of Medic ine, Lus Angeles, Callfur nia The current issue of the Journal of Interventional Cardiology is devoted to exploring the link between interventional cardiology and new concepts in the molecular approach to coronary artery disease. Interventional coronary technologies have. over the past decade, advanced at a prodigious pace. Using any or a combination of the currently available interventional devices, there are few lesions which can no longer be acutely recanalized with relative safety. These therapeutic advances, however, have been largely mechanical and reprebent a triumph of clinical research and biomedical engineering. Penistent problems remain with restenosis, thrombosis, and disease progression. It is likely that many of our newer therapeutic agents will be redesigned based on an improved understanding of the biology of vascular disease. The newest class of agents, the IIb/IIIa blocking drugs, clearly emanate from a major discovery in basic science related to the discovery of the IIb/IIIa receptor. Improved understanding of the biology of arterial thrombosis will likely result in further additions to our pharmacological armamentarium. Beyond this, understanding the vascular response to injury at the most elemental level-gene expression-will allow scientists and the pharmaceutical industry to conceive of, develop, and Address for reprints: Frank Litvack, M.D., Cardiovascular Intervention Center. P.O. Box 48750, Los Angeles, CA 90048-0750. Fa: (310) 967-0106. test a broad variety of newer therapeutic agents, including oligonucleotide and gene therapy. Subject matter that just a few years ago appeared lofty and of limited direct relevance to the interventionalist has now assumed more practical importance. As such, the next generation of interventional cardiologists will need a good working knowledge of the biology of the diseases they treat. This issue of the Journal is designed to provide an introduction as well as an overview of the important advances in basic science which are relevant in interventional cardiology. By the end of this decade, the multidevice, lesion specific approach to coronary recanalization should allow for minimally invasive treatment of even the most complex coronary lesions. New devices for recanalization of chronic total occlusions, improved stent technology and a better understanding of the role of “debulking†are just around the corner. Parallel developments with respect to novel bioengineered pharmaceuticals should provide effective adjunctive therapy with respect to restenosis, thrombosis, and possibly vascular remodeling. When these two disciplines-the mechanical and the biological-finally merge, minimally invasive therapy for the vast majority of patients with symptomatic coronary disease will become a cost-effective and safe reality. This should be achieved within the first decade of the next century and is likely to make coronary artery bypass surgery a relic of the 20th century. Vol. 8. No. 4. 1995 Journal of Interventional Cardiology
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