Interventional Cardiology Query

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Analyze and summarize key advancements and decision-making strategies in interventional cardiology. Address the following critical areas: 1. The evolution of percutaneous coronary intervention (PCI) from balloon angioplasty to modern drug-eluting stents. 2. Functional assessment of coronary lesions: Discuss fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and when these should guide revascularization. 3. Imaging advances: Compare intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in guiding PCI. 4. The role of CT coronary angiography (CTCA) in CAD diagnosis and how it compares to invasive coronary angiography. 5. The shift from femoral to radial access in PCI: Benefits, risks, and current guidelines. 6. Best practices for managing high-risk lesions, including bifurcations, calcified plaques, and chronic total occlusions. 7. The implications of stent thrombosis and restenosis: How drug-eluting stents and bioresorbable scaffolds address these challenges. 8. The future of interventional cardiology: Robotics, precision medicine, and AI-driven procedural planning. Create a structured framework for interventional cardiologists and internal medicine physicians, including: - Evidence-based decision trees for revascularization. - Risk stratification models for PCI versus medical therapy. - Clinical case scenarios illustrating guideline-driven interventions. - Cost-effectiveness considerations for advanced imaging and interventional techniques. Summarize key guideline changes from ACC/AHA and ESC, along with practical take-home points for optimizing patient outcomes.