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Editorial Message

Apr-07

Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief
April 2007
Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, commentary, letters to the editor, articles from our Rapid Communication and Clinical Images sections, and online case reports, as well as publication of the proceedings of the International Andreas Gruentzig Society session devoted to therapies for treating diffuse vascular disease, renal dysfunction, critical limb ischemia, and intracranial stenoses. These case reports and IAGS session selections can be found on our website (www.invasivecardiology.com). In the first original article, Dr. Shinichi Furuichi and colleagues from San Raffaele Scientific Institute and EMO Centro Cuore Columbus, Italy, present their study on the use of DES implantation in coronary trifurcation lesions, most of which involved the distal left main coronary artery. With a mean follow up of 19 months in 15 patients, there were no deaths, Q-wave MIs or stent thromboses, and 3 patients required TLR. Next, in an original research article from Dr. Robert Applegate and associates from Wake Forest University School of Medicine in Winston-Salem, North Carolina, a propensity score analysis of vascular complications after diagnostic cardiac catheterization and PCI using thrombin hemostatic patch-facilitated manual compression is described. These patches were demonstrated to be very effective at reducing manual compression time, permitted early ambulation, and were as safe as manual compression. In the next original research article, Dr. Katsuhisa Waseda and colleagues from Stanford University, present their study comparing the response of LAD versus non-LAD vessels following SES implantation assessed by serial 3-dimensional IVUS. Their study showed that there were minimal differences in vessel responses following stent implantation. Dr. Imad Sheiban and collaborators from Policlinico San Donato and University of Turin, present their study assessing the long-term clinical follow up of SES used for the treatment of bare-metal ISR. Their study showed that treatment of ISR with SES was safe and effective, with approximately a 10% annual rate of MACE, a majority of which were due to nontarget lesion events. Next, Dr. Chi-Hang Lee and colleagues from the National University Hospital in Singapore, describe their study using the Cura stent in the treatment of patients with ST-elevation MI. They found that use of the stent was feasible and safe in this patient group, although both the long-term binary restenosis rate and late loss at angiography were similar to BMS outcomes. Drs. Nanjundappa, Mandapaka, and Dieter have provided a commentary on this topic. In the final research article, submitted by Dr. Shaoliang Chen and associates from Nanjing Cardiovascular Hospital of Nanjing Medical University and Beth Israel Hospital, the double-kissing (DK) crush technique is compared to the classic crush technique for treatment of true coronary bifurcation lesions. The researchers found that the DK crush technique had shorter procedural times, higher success rates, less contrast usage, and less residual stenosis at follow up compared to the classic crush technique. This issue of the Journal also includes a selection from the Rapid Communication section. Drs. Kaluski, Tsai, and Cotter from the University of Medicine and Dentistry in Newark, New Jersey and Duke Cardiology Research Center in Durham, North Carolina, present their evaluation of the buried wire technique to enhance support for complex PCI and stenting in distal lesions. In the Clinical Images section, edited by Dr. David Rizik, Drs. Stéphane Cook, Bernhard Meier, and Stephan Windecker present images showing transseptal TandemHeart left ventricular assist device implantation through an Amplatzer atrial septal occluder. Be sure to look online to read this issue’s featured case report, in addition to seven other cases. In the featured case, Dr. Guilherme Bromberg-Marin and colleagues from the University of California, San Diego, present their successful management of a patient with spontaneous multivessel coronary vasospasm leading to anterior MI and cardiogenic shock in the setting of methylphenidate and withdrawal from beta-blockers and calcium-channel antagonists. In the first online case report, Dr. Jack Chen from Northside Cardiology in Atlanta, has provided a case of methamphetamine-associated acute MI and cardiogenic shock in a patient with normal coronary arteries. Next, Dr. Cagdas Ozdol and associates from Ankara University School of Medicine in Turkey, present a case showing their successful use of stenting during resuscitation in a patient with catheter-induced left main coronary artery dissection resulting in abrupt closure and cardiac arrest. Drs. Aziz, Morris, and Perry from the Royal Blackburn Hospital in Blackburn, U.K. and the Cardiothoracic Centre in Liverpool, report a case in which the patient developed late stent thrombosis associated with coronary aneurysm formation after SES implantation. In the next case report, Drs. Bradley, Schmoker, and Dauerman from Fletcher Allen Health Care and University of Vermont College of Medicine, describe an unusual case of Cypher™ stent fracture at the ostium of the RCA leading to migration of the fractured portion into the aortic root. Dr. Narayanan Namboodiri and colleagues from Thiruvananthapuram, India, present a patient with an unusual coronary anomaly in which a single coronary artery that originates from the right aortic sinus and where the LAD has a septal course and the RCA continues as the LCX. In the next case report, Drs. Aqel, Gupta and Zoghbi from Birmingham VA Medical Center and the University of Alabama at Birmingham, report their novel use of a FilterWire® EX distal protection device as a snare for clot extraction in a patient with acute ST-elevation MI due to occlusion of the RCA. In the last online case report, Dr. Adam Stys and colleagues from the University of South Dakota and the State University of New York at Stony Brook, provide a report on their use of a novel telescopic guide catheter system with contralateral aortic wall support to achieve optimum coronary guide catheter support. Also, please see the online publication of the Journal for a very enlightening discussion of various therapies for treating diffuse vascular disease, renal dysfunction, critical limb ischemia, and intracranial stenoses that occurred at the biennial International Andreas Gruentzig meeting. This discussion includes perspectives from Klemens Barth, Nick Hopkins, Siegfried Thurnher, Stefan Beyar-Enke, Klaus Mathias, and Dieter Liermann. And finally, this issue is completed with an interesting Letter to the Editor submitted by Dr. Nicholas Kounis and colleagues on the Kounis syndrome, and a reply to the letter from Dr. Brigitta Brott. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief

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