TITLE:
A New Era of Coronary Interventional Therapy: Precision Revascularization Strategies and Evidence-Based Innovations in Critical-Care Mechanical Circulatory Support
AUTHORS:
Nan Qin, Jianhong Qin
KEYWORDS:
Coronary Artery Disease, Percutaneous Coronary Intervention, Precision Revascularization, Cardiogenic Shock, Mechanical Circulatory Support, Fractional Flow Reserve, Microaxial Flow Pump, Drug-Eluting Stent
JOURNAL NAME:
Advances in Bioscience and Biotechnology,
Vol.17 No.11,
November
11,
2026
ABSTRACT: Over the past two decades, percutaneous coronary intervention (PCI) for coronary artery disease (CAD) has undergone a precision-oriented transformation from anatomy-guided to physiology- and intracoronary-imaging-guided practice. Iterative application of drug-eluting stents (DES) and drug-coated balloons (DCB) has substantially improved clinical outcomes. Nevertheless, cardiogenic shock complicating acute myocardial infarction (AMI) remains the most lethal complication of CAD, with persistently high mortality exceeding 40%. To date, considerable controversy persists regarding the selection of mechanical circulatory support (MCS) strategies. This narrative review summarizes advances in precision-oriented interventional strategies for CAD, covering fractional flow reserve (FFR)- and quantitative flow ratio (QFR)-guided PCI, stent optimization guided by intravascular ultrasound (IVUS) and optical coherence tomography (OCT), synergistic use of DES and DCB, and interventional breakthroughs for chronic total occlusion (CTO). On this basis, it analyzes MCS strategies for cardiogenic shock, compares clinical evidence for intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO) and microaxial flow pump, and discusses prospects for combined circulatory support regimens. This paper also reviews individualized decision-making for dual antiplatelet therapy (DAPT) duration and Chinese original evidence for periprocedural anticoagulation, aiming to provide evidence-based references for precision intervention and critical-care management of CAD.