Despite the recent advent of drug-eluting stents (DES), preparation of complex lesions (e.g., ostial, diffuse, fibrocalcified lesions and in-stent restenosis) before stent implantation remains an essential component of percutaneous coronary intervention (PCI).^1,2 Inadequate stent expansion has repeatedly been associated with restenosis and acute/subacute stent thrombosis.^3–7 Pretreatment with ordinary balloon catheters has not been shown to improve immediate- and long-term results of PCI.^8,9 Predilatation with high-pressure balloons may also l

Restenosis after percutaneous coronary intervention (PCI)occurs as a complex immune and proliferative response to injury. Even in the drug-eluting stent (DES) era, restenotic risk is not insubstantial, with reported rates of angiographic restenosis up to 18.9% and target vessel revascularization up to 12.1% in complex lesions or patients with diabetes mellitus.¹ Among preventative strategies, focus on optimization of stent expansion with adequate lesion preparation and minimization of vessel injury with avoidance of balloon slippage (“watermelon seeding”) has led to deve

Vascular access site complications are common following cardiac catheterization.¹ These complications, as high as 14% of patients undergoing percutaneous coronary intervention (PCI), increase hospital length of stay and cost.² Accordingly, vascular closure devices (VCD) were developed to decrease these complications and the time-to-hemostasis and ambulation. Since their introduction in 1995, many improvements such as utilizing biologics (collagen, thrombin and others) have helped to address these needs. However, little has been done to address the infectious complicati