Recent insights into the pathophysiology and implications for surgery in atherosclerosis

Atherosclerosis is a leading cause of cardiovascular disease. Recent advances in molecular biology have deepened our understanding of its pathogenesis and opened new avenues for surgical intervention.

This review integrates recent findings on key mechanisms-such as endoplasmic reticulum stress, oxidative imbalance, and immune-metabolic dysregulation-with progress in surgical and interventional strategies.

Novel targets like UPR pathways, mitochondrial ROS, and microRNAs have shown therapeutic promise. RNA-based lipid-lowering therapies and PCSK9 inhibitors offer alternatives to statins. In parallel, innovations in PCI and CABG-such as next-generation stents, multi-arterial grafting, and engineered vascular conduits-have improved safety and efficacy. Advanced imaging techniques further enhance diagnosis and procedural planning.

Integrating molecular insights with evolving surgical approaches is transforming atherosclerosis management. A precision strategy combining targeted therapy with individualized revascularization holds promise for better outcomes.