Volume 18 - Issue 2 - February, 2006

Percutaneous Retrograde Revascularization of Lower Extremity Vessels by Using the Dorsalis Pedis Artery: Two Case Reports

Peripheral artery disease (PAD) is commonly found in association with coronary artery disease (CAD) and is also considered a marker for CAD.1,2 There has been an increase in the treatment options for PAD with an increasing number of endovascular options becoming available.3 PAD involving the lower extremities usually presents with claudication, or in more severe cases, with chronic limb ischemia. Endovascular therapy for PAD in the lower extremities requires angiography of the affected vessel, followed by appropriate percutaneous intervention, if indicated. The commonly u

Coronary Bifurcation Stenting: From Crush to Culotte. Avoiding Limerence and Meme Propagation?

The Wikipedia term “crush” refers to a short-lived and unrequited love or limerence (“to crush on”). The primary characteristics of limerence can be summarized as intrusive, perhaps obsessive thinking about the limerent object and acute longing for reciprocation. Limerent people can act as a reservoir of memetic ideas as expressed in Karl Popper’s Conjectures and Refutations (1963). From his point of view, theories that better survive the process of refutation are actually not more true, but rather, more “fit”.1 The limerent attitude of interventional cardiologists to

Sequential Balloon Dilatation for Combined Aortic Valvular Stenosis and Coarctation of the Aorta in a Single Catheterization Pro

Combined aortic valvular stenosis (AVS) and coarctation of the aorta (CoA) is uncommon.3–5 This combination was detected in 7% of a large group of children with CoA who underwent balloon angioplasty.2 The long-term results of percutaneous balloon dilatation for isolated AVS and isolated CoA are favorable, and this treatment is widely used today, particularly for palliation.3–5
In 1987, Pan et al.6 reported the initial results for 2 patients with combined AVS and CoA who were treated with sequential balloon dilatation during a single catheterizat

Adjunctive Antiplatelet Therapy during Rescue PCI

The treatment of ST-segment elevation myocardial infarction (STEMI) continues to evolve due to the adoption of antiplatelet and anticoagulation regimens in combination with pharmacologic (fibrinolysis) and/or mechanical reperfusion. Rapid, complete and sustained restoration of infarct-related artery (IRA) blood flow and myocardial perfusion directly impacts patient outcomes, with improvement in left ventricular function and reduction in infarct size and mortality.1–5 Current fibrinolytic regimens appear to have reached a therapeutic ceiling, with normal (TIMI grade 3) IRA flow bei

Treatment of Spontaneous Coronary Dissection with Drug-Eluting Stents — Late Clinical, Angiographic and IVUS Follow Up

Spontaneous coronary artery dissection (SCAD) is a rare condition which may result in sudden coronary occlusion, acute myocardial infarction (AMI) and sudden cardiac death.1–3 We previously reported a case of SCAD involving the left anterior descending (LAD) artery confirmed with coronary angiography and intravascular ultrasound (IVUS).4 After failure of medical management, the patient was successfully treated with implantation of drug-eluting stents (DES), achieving a good immediate angiographic and intravascular ultrasound (IVUS) result with resolution of symptoms. We

Glycoprotein IIb/IIIa Inhibitors during Rescue Percutaneous Coronary Intervention in Acute Myocardial Infarction

Fibrinolytic therapy for acute myocardial infarction, even with the most efficient regimens available, is fraught with a substantial proportion of failures to re-establish normal blood flow in the occluded vessel.1,2 Failure to achieve prompt and complete restoration of TIMI 3 coronary blood flow after full-dose thrombolysis is associated with a poor prognosis.3 Although percutaneous coronary intervention (PCI), with or without stenting following full-dose thrombolytic therapy (rescue angioplasty), is a common procedure in these patients, data are scarce and there is ampl

Late “Adult Form” Scimitar Syndrome Presenting with “Infant Form” Complications

Scimitar syndrome is a rare congenital cardiopulmonary anomaly that carries a poor prognosis for individuals who are diagnosed within their first year of life.1 These patients often present with pulmonary hypertension and right-sided congestive heart failure, presenting a challenge for medical and surgical management. Conversely, scimitar syndrome is generally asymptomatic and often an incidental finding for patients diagnosed after infancy.2 We describe a previously healthy elderly patient who presented with pulmonary hypertension and congestive heart failure, and was ev

Percutaneous Transvenous Mitral Commissurotomy Using Metallic Commissurotome: Long-Term Follow-Up Results

Percutaneous transmitral commissurotomy (PTMC) has been established as an effective treatment for mitral stenosis (MS) and is now the procedure of choice.1–6 Of the procedures available to treat mitral stenosis, percutaneous valvotomy using the Inoue balloon is well established and carried out worldwide.
The miniaturized metallic commissurotome devised by Cribier et al. is reported to be a reliable and effective alternative to balloon mitral commissurotomy.7–11 The ease of resterilization and unchanged physical properties after multiple uses have made this device a p