February 2007

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Volume 19 Issue 2
RCA in RAO view. There are thin septal collaterals (arrows) to the LAD and collaterals from the PDA to the distal LAD.
Agenesis of the Left Main Stem: A Rare Cause of Sudden Cardiac Death
Case Report. A 32-year-old male suffered cardiac arrest out of hospital, was successfully resuscitated and transferred to our tertiary cardiac unit where we performed coronary angiography. Despite multiple attempts, the left main coronary artery (LMC…
Transvenous Pacing Causing Tamponade in Patients Receiving Glycoprotein IIb/IIIa Inhibitors for Percutaneous Coronary Interventi
A backup temporary pacing wire is often used in patients with heart block undergoing cardiac catheterization and percutaneous coronary intervention (PCI). It is particularly recommended for any patient undergoing rotational atherectomy or rheolytic t…
Transesophageal echocardiography (TEE) of the prosthetic mitral valve with left atrium adjacent to the transducer. (A) A 6 mm defect is present (black arrow) adjacent to the mitral valve sewing ring on the lateral aspect of the left ventricle near the lef
Paravalvular Mitral Regurgitation Treated with an Amplatzer Septal Occluder Device: A Case Report and Review of the Literature
Case Report The patient is a 62-year-old male with a past medical history significant for hypertension, hyperlipidemia and coronary artery disease. In October 2004, he developed congestive heart failure and was diagnosed with severe mitral regurgitat…
1. Coronary angiogram shows that the first obtuse marginal (OM) branch is totally occluded at the ostium (A, RAO caudal view). The OM branch was successfully recanalized and a sirolimus-eluting stent was implanted (Cypher 3.0 x 23 mm) (B). The stent was p
Fractured DES with a Patent Coronary Artery: Clinical Implications
Drug-eluting stents (DES) have, for the most part, replaced bare-metal stents (BMS) as a safe and effective therapeutic modality for treating coronary stenosis. Post-DES restenosis with sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES…
Radial artery larger than ulnar (antero-posterior film, palm facing upwards). (A) Brachial artery; (B) small recurrent radial; (C) ulnar; (D) small recurrent ulnar; (E) Radial and ulnar arteries overlayed; (F) common interosseous; (G) radial; and (H) smal
Transulnar Access for Coronary Angiography and Intervention: An Early Review to Guide Research and Clinical Practice
Percutaneous coronary intervention and coronary angiography are increasingly performed via radial artery access after resurrection of this route by Campeau in 1989.1 The reasons for this are reduced local complication rates compared to procedures usi…
Cardiac MRI gradient echocardiogram of the coronal oblique view showing communication between the left ventricular pseudoaneurysm and the left ventricle. LVPA = pseudoaneurysm; LV = left ventricle.
Large Mitral Annular Left Ventricular Pseudoaneurysm Detected by Cardiac Magnetic Resonance Imaging
Case Report. A 57-year-old white female school teacher had undergone mitral valve replacement 8 months earlier for streptococcal endocarditis and had required subsequent repair of a paravalvular leak 2 months later. The patient recently fell and frac…
Renal V-Stenting
An 83-year-old male with a recent history of arterial hypertension and progressive renal failure was referred for an elective percutaneous intervention of a bilateral renal artery stenosis, i.e., an ostial lesion of a left inferior renal polar artery…
The Benephit Introducer Sheath positioned in the infrarenal aorta. Note the opaque catheter tips within the sheath (A).
Multifactorial Acute Renal Failure Treated with Percutaneous Targeted Renal Therapy (TRT): A Case of “Dialysis Rescue”
Targeted renal therapy (TRT) with direct intrarenal artery fenoldopam (FEN) infusions were used to treat a multifactorial acute renal failure (ARF) patient with acute limb ischemia, contrast-induced nephropathy (CIN) and sepsis. TRT was initially inf…
Visualization of renal arteries in a patient with hypertensive emergency. MRA of the abdominal aorta and renal arteries (A).
Hypertensive Emergency in a Young Adult: Diagnosis of FMD by Renal Angiography But Not MRI/MRA
Hypertensive emergency (also referred to as malignant hypertension) is defined by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) as severe elevation in blood press…
Baseline angiography of the left lower limb, disclosing long and total occlusions of the anterior tibial, dorsalis pedis, and posterior tibial arteries, critical stenoses of the peroneal artery, with a patent plantar branch (A and B show the proximal tra
Pedal-Plantar Loop Technique for a Challenging Below-the-Knee Chronic Total Occlusion: A Novel Approach to Percutaneous Revascul
Arterial revascularization by means of percutaneous transluminal angioplasty (PTA) is being increasingly used for the treatment of patients with severely symptomatic peripheral artery disease (i.e., those with critical limb ischemia). This phenomenon…