Editorial Message October 2002

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, case reports, and articles from the Journal special sections “Interventions in Peripheral Disease”, “Acute Coronary Syndromes” and “Interventional Pediatric Cardiology”. The first research article, submitted by Dr. Paul Gurbel and colleagues from the Sinai Center for Thrombosis Research at Sinai Hospital in Baltimore, Maryland, presents data that substantiates the speculation that stent design may induce platelet activation. Their study of open versus closed-cell stent design demonstrated more platelet activation 30 days post implantation in the open-celled stent design. In the second research article, Dr. Christoph Bickel and collaborators from the Medical Clinic and Departments of Medical Statistics and Documentation at the Johannes Gutenberg University Mainz in Germany present a study comparing TIMI Flow classification with Corrected TIMI frame counts, showing that TIMI frame counts were superior in detecting coronary flow changes. In an accompanying commentary, Dr. Rafael Beyar from the Rambam Medical Center in Haifa, Israel, comments that while all methods are important, they should be further developed. In the last original research article, Dr. Young-Hak Kim and colleagues from the Department of Medicine at the University of Ulsan College of Medicine and the Cardiac Center at the Asan Medical Center in Seoul, Korea examined the association between diabetic retinopathy and late events following PCI. They found that diabetic patients with retinopathy had a lower survival rate at 2 years post PCI, but there were no differences in other major cardiac events. This issue of the Journal also includes two case reports with brief reviews of the literature and five interesting case reports representing unusual clinical presentations. The first two case reports include a review of relevant literature as well as interesting clinical situations. Drs. D’Agate, Schwartz and Lazar present the first case showing that coronary artery spasm can produce arrhythmias as well as angina. They follow the case presentation with a thorough review of the literature that exists on this subject and make treatment recommendations based on this review and discussion. The second case report and review is from Drs. Arjomand, Aquilina and McCormick from the Division of Cardiology and Department of Medicine at MCP Hahnemann University in Philadelphia. They relate their experience in treating a patient presenting for treatment of an acute MI who also has von Willebrand disease and present a literature review of the major treatment options available for this clinical scenario. In the first case report, Drs. Pershad, Cherukiri and Kirby from St. Luke’s Medical Center in Phoenix, Arizona describe a case in which thrombus formed at the site of the distal occlusive balloon of the Percusurge distal embolic protection system, limiting its effectiveness as an adjunct embolic protection in the treatment of a saphenous vein graft. In the second case report, submitted by Drs. Nedeljkovie, Ostojie and Beleslin from the University Institute for Cardiovascular Diseases, Department of Diagnostic and Catheterization Laboratories at the Clinical Centre of Serbia in Belgrade, Yugoslavia, the authors describe their approach to successfully treating the condition of medically uncontrolled coronary artery spasm using stenting in a patient with an atherosclerotic-free coronary artery. In the third case report, Dr. Henry Lowe and associates from Massachusetts General and Harvard Medical School in Boston, Massachusetts describe the massive release of atheromatous material released in a patient who had successful direct stenting of a saphenous vein graft. They offer histologic evidence that supports the routine use of distal protection devices in these kinds of interventions. In the fourth case report, Drs. Macina, Torosoff and Millar from the Divisions of Cardiology and Medicine at the Albany Medical College in Albany, New York show an interesting patient who has spasm of a radial artery that was used as a conduit in a coronary artery bypass graft surgery. In the last case report, Drs. Kobayashi, Al-Mubarak, and Moses report on a case of PCI performed on a lesion located in a sequential radial artery graft anastomosed to the descending aorta, distal circumflex artery and obtuse marginal artery. This issue is completed with articles from three of our special clinical sections. In the first special section, Acute Coronary Syndromes, edited by Dr. Lloyd Klein from the Section of Cardiology, Rush Heart Institute at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, Illinois, Dr. Klein along with collaborators Drs. Barry Merrill and James Calvin, present a model using Troponin I levels and standard risk factors to enhance prediction of in-hospital events in intermediate and high risk patients presenting with acute coronary syndromes. In the next special section, Interventions in Peripheral Vascular Disease, edited by Dr. Frank Criado of the Division of Vascular Surgery at the Union Memorial Hospital/Medstar Health in Baltimore, Maryland, Dr. Criado has included a case report from Dr. Vittorio Ambrosini and associates from the Department of Invasive Cardiology at the Montevergine Clinic in Mercogliano, Italy. The authors present a patient treated with a stent-in-stent technique and tirofiban for a femoral artery stenosis. The last special section, which covers advances in the field of Interventional Pediatric Cardiology and is edited by Dr. P. Syamasundar Rao from the Division of Pediatric Cardiology at Saint Louis University School of Medicine in St. Louis, Missouri, includes an article submitted by Drs. Recto, Bousamra and Yeh from the University of Louisville in Louisville, Kentucky. In their article, the authors present a case involving a 13-year-old patient who had a late perforation of the superior vena cava and laceration of the ascending aorta after stent implantation. The authors include a thorough discussion and offer insight into the effective treatment of this clinical presentation. It is my hope that all of the articles in this issue of the Journal provide information that is useful for cardiovascular specialists in their daily care of patients with cardiovascular disease.