Dear Readers,

This issue of the Journal of Invasive Cardiology, includes original research articles, commentary and features from our special journal sections. In addition, I encourage you to visit the website edition to read the interesting and informative case reports that are part of this issue : www.invasivecardiology.com
The first research article, submitted by Dr. Matthew Price and collaborators from the Scripps Clinic, Columbia University and the Cardiovascular Research Foundation in New York, presents their double-blind, randomized, dose-finding study of gamma intracoronary radiation therapy to inhibit recurrent restenosis after stenting. In this report they found that a higher than standard dose (17 Gray rather than 14 Gray) was more effective in reducing target lesion revascularization and the composite endpoint of death, myocardial infarction, thrombosis or TLR.

In the next original article, Dr. Vinicius Vaz and collaborators from the Instituto Dante Pazzanese de Cardiologia in Sao Paulo, Brazil have provided results of their study using angiography and 3-D intravascular ultrasound to assess the longterm follow-up of diabetic patients treated with sirolimus-eluting stents (SES). They demonstrated that the 18-month angiographic and ultrasound results were similar to the 6-month results, suggesting that SES are safe and effective in diabetics and do not appear to have the late “catch-up” phenomenon.

Dr. John Coppola and collaborators from St. Vincent Catholic Medical Centers in New York present their study of nitroglycerine, nitroprusside, or both in preventing radial artery spasm during transradial artery catheterization. They found that there was a similar rate of spasm regardless of treatment, and that radial artery diameter/height index and sheath outer diameter were the major predictors of spasm. Dr. Ferdinand Kiemeneij has provided an editorial to accompany the article by Coppola et al.

Next, Dr. Mark Eisenberg and associates from the Jewish General Hospital/McGill in Montreal, Quebec report on their study of the benefit of routine functional testing early after coronary artery bypass surgery in the ROSETTA-CABG registry. They demonstrated low event rates one year after CABG and that the strategy of routine testing does not appear to be warranted. Drs. Michael Lauer and Stephen Ellis of the Cleveland Clinic Foundation have provided a commentary on this topic.

Dr. Zakaria Khurram and colleagues from the Lenox Hill Hospital, Kaiser Permanente and Weill Cornell Medical College in New York present their work assessing the effect of combination therapy that includes aspirin, clopidogrel and warfarin following coronary stenting on the risk of bleeding. They found that stent patients on chronic warfarin therapy who also took aspirin and clopidogrel had a significantly higher rate of major and minor bleeding compared to stent patients on standard aspirin and clopidogrel therapy.

In the last original research article, Dr. Marc Schweiger and collaborators from the Baystate Medical Center, Tufts University report on their study designed to characterize the morphology and location of restenosis following bare metal coronary stenting. Their study showed that a large number of patients have restenosis outside the stent, suggesting that methods other than local stent delivery of inhibitors may be required to reduce restenosis.

Drs. John Macdonald, Manivannan Srinivasan and Ranjit More at Blackpool Victoria Hospital in the United Kingdom, look at the use of PCI in a patient with von Willebrand’s Disease who presented with acute coronary syndrome in the “Rapid Communications” article. They present the factors arguing for the use of PCI in a patient with acute coronary syndrome, and review the literature to highlight the issues in the treatment of this condition. Drs. Bonnie Ky, Marjorie Kasner and Joseph Carver build on this discussion in a commentary they have provided on this topic.

We have also featured a case report from Drs. Edward Yoon, Ernest Haeusslein and Bruce Brent from the California Pacific Medical Center in San Francisco that presents longterm follow up after successful placement of an SES for cardiac transplant arteriopathy complicated with AMI. In the online cases section, Drs. Vijayvergiya, Swamy and Grover from the Post Graduate Institute of Medical Education and Research in Chandigarh, India describe their use of the buddy wire technique to treat calcified lesions during PCI. Next, Drs. Limbruno, Ebert and Galli from Livorno Hospital in Livorno, Italy describe a case of acute coronary syndrome treated with PCI and distal protection complicated by filter entrapment into the stent struts, offering strategies to deal with this type of situation. Drs. Varotto, Vecchia and Fontanelli from Vicenza, Italy present a heart transplant patient in which abciximab was used to treat ST elevation acute myocardial infarction followed by direct stenting. Next, Drs. Dorsch, Seidelin and Blackman from the Yorkshire Heart Centre in the United Kingdom and the Toronto General Hospital in Ontario present their successful percutaneous management of a patient who had an occlusion of a saphenous vein graft due to complete stent fracture. Drs. Gupta, Sapra and Kaul from the Batra Hospital and Medical Research Centre in New Delhi present a case and brief review of the literature describing the unusual occurrence in two patients of early aneurysm formation after drug-eluting stent implantation. In the last online case report, Drs. Jamali, Lee and Makkar from Cedars-Sinai Medical Center in Los Angeles, California present a case in which they used a local thrombin injection to treat a rare, yet life-threatening complication of coronary perforation after PCI.

In Clinical Images, Drs. Mostafa Dastani, Vahid Jorat, and Bernhard Meier from the University Hospital Bern in Bern, Switzerland presents the first images of an anatomical variation of the interatrial septum that may occur in some patients being treated with percutaneous closure of the foramen ovale.

It is my hope that each of the articles in this issue of the journal provides cardiovascular healthcare professionals with information that improves the daily care of cardiac patients.

Sincerely,

Richard E. Shaw, PhD, FACC, FACA
Editor-in-Chief