Dear Readers, This issue of the Journal of Invasive Cardiology commences our 17th year of publication. The growth of the journal over the last year has been phenomenal. I want to thank the staff at HMP Communications for providing the support that was essential for this growth. None of this would have been possible without our editorial board members who spend countless hours reviewing manuscripts submitted to the journal. And last, but by no means least, I want to thank the authors who continue to contribute high quality material for publication that makes the Journal of Invasive Cardiology the journal of choice for our readership. This issue of the journal includes original research articles, commentaries, case reports, and articles from the journal special sections Intervention in Peripheral Vascular Disease, Adjunctive Therapy, Clinical Decision Making, and Continuing Medical Education. In the first research article, Dr. Chi Hang Lee and collaborators from the National University Hospital present their study to evaluate the safety and feasibility of X-sizer facilitated rescue PCI for treatment of ST-segment-elevation MI after failed thrombolysis. They showed that X-sizer facilitated PCI outcomes were comparable to those achieved in primary PCI of STEMI. In the second original research article, Dr. Pramod Kuchulakanti and collaborators from the Washington Hospital Center in Washington, D.C. provide a study that addresses the issue of the impact of pretreatment with clopidogrel prior to cardiac catheterization in patients who require coronary artery bypass graft surgery. Their study demonstrated that continued hospitalization of patients following discontinuation of clopidogrel prior to surgery did not confer any benefit compared to patients discharged immediately after their catheterization procedure. Dr. Steven Goldberg has provided a commentary to accompany the Kuchulakanti et al. article. Next, Dr. Maniyal Vijayakumar and colleagues from the Thoraxcenter, Erasmus Medical Center, The Netherlands present their study of immediate and longterm outcomes achieved using sirolimus eluting stents in the treatment of ostial lesions. They found that these stents were effective in reducing subsequent need for revascularization. Drs. Shahid Aziz and David Ramsdale have provided a commentary to accompany this article. In the fourth original article, Dr. Koichi Kishi and colleagues from the Tokushima Red Cross Hospital report on their experience in performing rotational atherectomy prior to stenting for ostial LAD and ostial LCS stenoses in diabetic patients. Angiographic follow-up demonstrated that diabetic patients were more likely to have a significantly higher rate of restenosis as well as development of new left main narrowing or non-treated artery ostial narrowing. The next contribution, submitted by Dr. Michael Lee and colleagues from the Division of Cardiology at St. Luke’s-Roosevelt Hospital Center in New York, New York, is a study designed to determine if aminophylline, an adenosine receptor antagonist, is effective in controlling transient bradyarrhythmias that occur with the use of the Angiojet in thrombectomy in the setting of acute MI. Their study demonstrated that the drug is not effective in preventing bradyarrhythmias and that transvenous pacing is required. A very thoughtful commentary has been provided by Dr. Michael Lim from St. Louis University. In the next original research article, Dr. Mehrdad Saririan and collaborators from McGill University Health Center, Jewish General Hospital in Montreal, Geisinger Medical Center in Danville, Pennsylvania and Manhattan Veterans Affairs Medical Center in New York have submitted their study assessing routine versus selective functional testing after PCI in patients with diabetes mellitus. Their results showed that routine functional testing offered little value over selective, symptom driven testing. The last original research article was submitted by Dr. Kenya Nasu and associates from the Osaka Medical Center for Cancer and Cardiovascular Disease, Rinku General Hospital and Shiga Center for Adults. They present their research assessing the safety and efficacy of pre-placement of the Closer™ 6 Fr suture-mediated closure device in patients under-going PCI. They showed that these results were comparable to those achieved with the Prostar® XL closure device. This issue of the journal contains articles from four of the special sections. In the first special section, Adjunctive Therapy, edited by Dr. Deepak Bhatt, Director of the Interventional Cardiology Fellowship at the Cleveland Clinic Foundation, Dr. Umesh Arora from the University of South Florida has provided part one of his excellent review of direct thrombin inhibitors. Two articles are included in the Interventions in Peripheral Vascular Disease section, edited by Dr. Frank Criado of the Division of Vascular Surgery at the Union Memorial Hospital /Medstar Health in Baltimore, Maryland. In the first article, Drs. Rajiv Maraj and Ronald Gim of the University of California-Irvine Medical Center and Dr. Rex Winters of Long Beach Memorial Medical Center describe the first clinical experience with a rapid exchange nitinol self-expanding stent in combination with balloon-expandable coronary stents following thrombolysis of femoral-popliteal artery bypass graft occlusion. In the second article, Drs. Greg Mishkel and Nilesh Goswami from Prairie Cardiovascular Consultants have submitted a review of endovascular therapy for infrapopliteal disease and the treatment of critical leg ischemia. In the Clinical Decision Making section, edited by Dr. Michael H. Sketch, Jr. from Duke University Medical Center, we feature the management of focal in-stent restenosis in a large right coronary artery previously stented with a 5.0 x 43 mm Magic Wallstent. The case is described by Drs. C. H. Smith, M. B. Erwin, and E. N. Deliargyris from Wake Forest University and additional treatment opinions are offered by Dr. David R. Ramsdale from the Cardiothoracic Centre in Liverpool and Dr. Nicolas W. Shammas from the Midwest Cardiovascular Research Foundation in Davenport, Iowa. In our Continuing Medical Education Section, we have an article discussing early ambulation strategies with contrast management from Dr. Michael Lim from St. Louis University in St. Louis, Missouri. This issue of the journal also includes a case report in which Dr. Amgad Makaryus and colleagues from North Shore University Hospital describe an unusual patient who presented with suspected coronary artery disease who was found to have an anomalous origin of the left coronary artery from the right coronary artery, a rare case of single coronary artery originating from the right sinus of Valsalva. Drs. Thompson, Ferraris and Gress from the Departments of Cardiology at Marshall University School of Medicine and the Department of Surgery at the University of Kentucky describe a series of patients who presented with spontaneous coronary artery dissection. They include a brief review in which they discuss the factors found to be significant predictors of mortality, including female gender. It is my hope that all of the articles in this issue of the journal provide information that is useful for cardiovascular specialists in their daily care of patients with cardiovascular disease.