ISSUE @ A GLANCE Interventional cardiology: successes and failures

Ever since the seminal first balloon angioplasy in a young patient with angina pectoris on 16 September 1977 by the late Andreas R. Grüntzig at the University Hospital Zurich,1 interventional cardi-ology has contributed importantly to the rise of cardiovascularmedi-cine.2With the advent of drug-eluting stents, restenosis has become less important,3 butwhetherornot it affectshardoutcomes including mortality, or represents a clinical nuisance only is still a matter of debate.Whetherwe really use percutaneous coronary interventions (PCIs) only in those patients who truly need it has also been ques-tioned by many critics of current clinical practice.4 Finally, although primary PCI has become the standard of care in acute coronary syndromes (ACS), the event rate in the years there-after remains high, particularly due to the development of systolic dysfunction and heart failure. Thus, the possibility of improving current ACS management further, for instance by limiting reperfu-sion injury (thereby protecting the myocardium), is another open question. Almost all pharmacological interventions have failed, although pre-conditioning appears to be promising.5 Grüntzig started in coronary circulation, but structural interven-tions have recently become almost as important. Catheter-based interventions for aortic stenosis ormitral regurgitation have success-fully been introduced in selected patients.6 In contrast, percutaneous closure of a patent foramen ovale (PFO) in patients with cryptogenic stroke is an effective procedure and is very controversial. All these open issues of interventional cardiology are addressed in the current issue of the European Heart Journal. The first paperof this issueon ‘Prognostic role of restenosis in 10 004 patients undergoing routine control angiography after coronary stenting ’ by Adnan Kastrati and co-workers7 from the Deutsches Herzzentrum in Munich, is a FAST TRACK accompanied by an excellent Editorial by Johann Auer from the General Hospital in Braunau, Austria,8 was presented at th