May-04

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, case reports and articles from the journal special sections Acute Coronary Syndromes, Clinical Decision Making, Intervention in Peripheral Vascular Disease and Clinical Images. In the first original research article, Dr. Angela Hoye and collaborators from the Thoraxcenter, Rotterdam, The Netherlands and the Department of Interventional Cardiology Erasmus, Rotterdam present their study of the effectiveness of using sirolimus-eluting stents in the treatment of saphenous vein graft disease. They showed that there was a low rate of target vessel revascularization necessary in this group of patients. Drs. Sam McClure and John Webb have provided a thoughtful commentary with extensive references to accompany the Hoye et al. article. In the next research article, Dr. Robert Medina and Denise Foto report a retrospective analysis on 186 patients receiving PCI and DES placement. They compared the use of bivalirudin and heparin and how the addition of GP IIB/IIIa inhibitors might affect the outcome. They found that the use of GP IIb/IIIa inhibitors does not eliminate the risk of subacute thrombosis and that bivalirudin appears to provide effective anticoagulation during DES placement. Dr. Raoul Bonan has provided a commentary on this topic. In the third paper, Dr. Matthias Kunert and colleagues from the Department of Cardiology, Marienhospital Bottrop, Germany and the University of Witten-Herdecke present their findings in using the FemoStop system for closing the arterial puncture site following percutaneous coronary intervention. They found that in the setting of aggressive heparin use, this device may not be advisable due to prolonged femoral artery compression times. In the fourth research article, Dr. Paul Vaitkus from the Cardiology Division at the University of Illinois at Chicago presents a well-done meta-analysis examining the use of percutaneous vascular closure devices after diagnostic catheterization and percutaneous coronary intervention. He demonstrated that in general closure devices are associated with a reduction in complications, but there is a significant amount of variance that exists among individual types of devices used. Next, Dr. Holger Eggebrecht and colleagues from the Department of Cardiology at the University of Duisburg, University Hospital at Essen and the West German Heart Center in Essen, Germany present their research on the impact of gender on femoral access site complications secondary to the application of a collagen-based vascular closure device. Their study found that women had a higher incidence of severe complications, even with similar success for device placement compared to men. Drs. Kul Aggarwal and Muhammad Murtaza have provided a commentary to accompany the Eggebrecht et al. article. The sixth research article reports the experience of Dr. Hans Bonnier and colleagues from the Thoraxcernter in Rotterdam on their initial experience using the six-cell Tsunami stent system. In-hospital results were excellent and 6-month in-stent restenosis was 13.8%, indicating that the stent is a safe and effective treatment. For the final research article, Dr. William Weintraub and colleagues from the Division of Cardiology at Emory University in Atlanta, Georgia have provided a paper outlining the methods for economic and quality of life assessment used in the Cilostazol for Restenosis (CREST) Trial. This issue of the journal also includes several case reports and one case report with a brief review of the literature. In the first case report, Dr. Carlos Cafri and colleagues from the Cardiology Department at Soroka Medical Center in Beer Sheva, Israel report an unusual complication of the X-Sizer Thrombectomy device in which there was a fracture of the coronary guidewire. The case was successfully salvaged and the authors discuss possible reasons for the complication. Dr. Hurkan Kursaklioglu and colleagues at the Gulhane Military Medical Academy, Department of Cardiology, Etlik, Ankara-Turkey describe an unusual coronary anomaly where intracoronary communication existed between the right coronary artery and the circumflex artery with unidirectional blood flow. Drs. Akram Abu-Ful and Yaakov Henkin from the Cardiology Department at Soroka Medical Center and Faculty of Health Sciences at Ben Gurion University in Beer Sheva, Israel have also focused on anomalous coronary arteries, outlining their successful stent treatment of a patient with a single coronary artery ostium arising from the right coronary Sinus of Valsalva. In the next case report, Dr. Pavel Cervinka and colleagues from the departments of Cardiology at Masaryk’s Hospital Usti nad Labem and Faculty Hospital Hdradec Kralove in the Czech Republic describe a case of atrial septal defect closure in which the repositioning of an Amplatzer device embolized into the left atrium and resulted in successful treatment. In the next case report, Dr. Michael Lee and collaborators describe their use of the Angiojet and a JoStent stent graft to successfully treat a patient who presented with in-stent restenosis and 2 aneurysms proximal to the stent lesion, In a multiple case report that also focuses on anomalous coronary arteries, Dr. Thanh Nguyen and colleagues from the Section of Cardiology and the Department of Medicine at Louisiana State University Health Sciences Center in New Orleans, Louisiana and the Departments of Cardiology at Medical Center of Louisiana and Touro Infirmary in New Orleans report on 5 cases in which they utilized stenting for treatment of atherosclerotic lesions. This issue of the journal also includes selections from 4 of the special journal sections. In the first special section, “Clinical Decision Making”, edited by Dr. Michael Sketch from Duke University, Dr. Sketch has selected an interesting case from Drs. Thuraia Nageh and colleagues in which a left main coronary artery dissection was discovered using IVUS after an angiographically successful PCI. Dr. John Young of the Lindner Center for Research and Education at the Ohio Heart Health Center, Drs. Victor Mejia and Joseph Carver from the Division of Cardiology at the University of Pennsylvania and Drs. Larry Diaz-Sandoval and Ik-Kyung Jang at Harvard Medical School have provided their thoughts and approaches to this challenging clinical scenario. In the next special section, “Clinical Images”, edited by Dr. David Rizik from Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona, Dr. Rizik and associates present multiple modalities substantiating the potential for myocardial salvage utilizing direct intracoronary infusion of Aqueous Oxygen. In the next special section, “Acute Coronary Syndromes”, edited by Dr. Lloyd W. Klein of the editorial board, Dr. Klein has invited Drs. Arjomand, Cohen and Ezekowitz from the Divisions of Cardiology at Hahnemann University Hospital in Philadelphia and Newark Beth Israel Hospital in Newark, New Jersey to review combination antithrombotic therapy with antiplatelet agents and anticoagulants for patients with atherosclerotic heart disease. This review is comprehensive and covers agents that have sometimes been overlooked in the literature. The last special section, “Intervention 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, Drs. Spratt, Leslie and Verin from the University Hospital of Geneva and the Royal Infirmary of Edinburgh a case of renal brachytherapy for in-stent restenosis with longterm follow-up. It is my hope that the articles in this issue of the journal provide cardiovascular specialists with new perspectives for meeting the challenges they face in the daily treatment of patients with cardiovascular disease.