Volume 14 - Issue 2 - February, 2002

February 2002 Editor's Message

Dear Readers,

This issue of the Journal of Invasive Cardiology includes original research articles, case reports, articles from the Journal special section “Clinical Decision Making”, a teaching collection, and the new special section “Acute
Coronary Syndromes”.

The first research article, submitted by Dr. Christoph Hehrlein and collaborators from the Department of Cardiology at the University of Freiberg in Germany and the Heart Institute at Borgess Medical Center in Kalamazoo, Michigan, describes a novel indexing system used to compare residual stenosis following the



The Draw-Back Stent Deployment Technique: A Strategy for the Treatment of Coronary Branch Ostial Lesions

Treatment of isolated ostial lesions of sidebranches continues to represent a challenge for the interventional cardiologist. In some ways similar to aorto-ostial lesions, these lesions are highly elastic and subject to recoil and so are unsuitable for conventional balloon angioplasty. Mathias et al.1 reported a primary success rate with balloon angioplasty of only 74%. Procedural success with rotational atherectomy is better at 94%, but the angiographic restenosis rate is still high at 44%.2 Because they prevent elastic recoil, stents represent an attractive approach to the recanalization of t



Report of an Undeployed Stent Causing the Unraveling of a Coronary Artery Guidewire Being Used for Sidebranch Protection

Coronary guidewire fracture and subsequent retrieval of the retained pieces is an uncommon, but known complication of percutaneous coronary angioplasty. To our knowledge, however, this is the first report of a coronary guidewire unraveling after positioning an undeployed stent, and its successful retrieval by removal of the undeployed stent.

Case Report. A 70-year-old male who had hypertension and hypercholesterolemia was treated with primary angioplasty of his proximal right coronary artery during an acute myocardial infarction 10 weeks prior to this admission. Because of continued



Unusual Mechanism of Coronary Perforation During PTCA

Case Description. A 79-year-old female with history of hypertension, hyperlipidemia and peripheral vascular disease underwent successful direct stenting of her left anterior descending coronary artery on March 15, 2000 in the setting of unstable angina, utilizing a 3.0 x 15 mm Medtronic/AVE S670 stent deployed at 16 atmospheres (Medtronic-AVE, Santa Clara, California). Follow-up coronary angiography on September 1, 2000 for recurrent angina revealed angiographically significant in-stent focal restenosis (Figure 1). Intravascular ultrasound (IVUS) was performed to address the possible un



Facilitated Percutaneous Intervention Following Combination Therapy with Reteplase and Abciximab for Acute Myocardial Infarcti

Case Report. R.C. is a 45-year-old white male who presented to the Emergency Department at Largo Medical Center with a massive acute anterior wall myocardial infarction (MI). The patient denied any prior history of coronary artery disease (CAD), but admitted to intermittent chest pain over the preceding week. He had a moderately severe episode of chest pain lasting nearly 2 hours the evening before this event but the symptoms resolved spontaneously and he attributed the symptoms to indigestion. He was previously treated by his primary care physician with statin therapy for “mild” hy