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Recurrent in-stent restenosis (R-ISR) refers to the re-occlusion of a successfully treated in-stent restenosis. Much of the present understanding of this condition stems from studies on in-stent restenosis, as literature on R-ISR is sparse. Compounded by multiple previous struts, narrower luminal diameters and worse patient profiles, R-ISR is a clinical challenge that demands urgent attention. Recent studies have explored various diagnostic and therapeutic strategies to identify and suitably manage R-ISR. In this review, we discuss our understanding of the risk factors, invasive and non-invasive imaging techniques, therapeutic options and gaps in present knowledge for the management of R-ISR.

Background The "weekend effect" is a purported phenomenon whereby patients admitted for time-sensitive medical and surgical conditions on a weekend suffer worse outcomes than those admitted on a weekday. There are limited data on the weekend effect for nonelective coronary artery bypass grafting (CABG). Methods We studied outcomes for weekend vs weekday operations for all adult patients in the 2013 to 2014 National Inpatient Sample (NIS) undergoing nonelective CABG. Results Of 101,510 patients undergoing nonelective CABG, 12,795 patients (12.6%) underwent CABG on the day of admission (n = 1230 for weekend and 11,565 for weekday admission, respectively). Patients undergoing surgical procedures on a weekend were more likely to have a diagnosis of ST-elevation acute coronary syndrome (47.2% vs 20.2%, P Conclusions Patients undergoing CABG on a weekend had higher crude mortality but similar risk-adjusted mortality compared with their weekday counterparts. Some of the excess mortality observed for weekend operations is likely attributable to a sicker cohort of patients undergoing CABG on the weekend.

Patients undergoing transcatheter aortic valve replacement (TAVR) routinely undergo coronary angiography prior to the procedure to define the coronary anatomy and evaluate the extent of coronary artery disease (CAD). Whether percutaneous coronary intervention (PCI) prior to or concomitant with TAVR