Recent insights into the pathophysiology and implications for surgery in atherosclerosis

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.