The development of pre-mounted stents, as well as numerous technical enhancements, have contributed to the improvement of stent profile, flexibility and safety. Stent placement without predilation has become feasible and can virtually be carried out by all interventional cardiologists. Indeed, after a number of successful preliminary experiences, the operators have been able to modify their implantation techniques and to start performing direct stenting routinely in selected patients.1–5 In this setting, the questions remain: What patients are eligible for direct stenting? Are there still co

Although acute and late results of coronary intervention have been obtained by coronary angiography and this method might be sufficient for daily practice, angiography is a luminology1 and cannot reveal changes in vessel and plaque volume. On the other hand, use of intravascular ultrasound (IVUS) allows transmural, tomographic imaging of coronary arteries in humans in vivo, providing insight into the pathology of coronary artery disease. Furthermore, the time course of vessel remodeling after directional coronary atherectomy (DCA) has recently been evaluated by volumetric analysis with IVUS.2,

Surgical closure of congenital or acquired [post-myocardial infarction (MI)] muscular ventricular septal defects (MVSD) is still associated with significant mortality and long-term morbidity.1,2 Different surgical approaches have been suggested, requiring either a right or left ventriculotomy.3,4 Over the past few years, devices designed originally for percutaneous closure of atrial septal defects or patent ductus arteriosus have been used to close MVSDs with variable degrees of successful closure and residual shunts.5–10 Lock et al.5 first reported the transcatheter occlusion of a VSD using