September 2014

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Volume 26 Issue 9
Anchoring Improved: Introduction of a New Over-the-Wire Support Balloon
A patient is presented with symptomatic right coronary artery (RCA) CTO who failed maximal medical therapy as well as multiple antegrade PCI attempts. Successful RCA CTO intervention was finally achieved using a novel over-the-wire balloon catheter (…
Multivessel Giant Coronary Artery Aneurysms in an Adult With an Acute Coronary Syndrome: Latent Finding of Kawasaki Disease
We present a case of a patient with an acute coronary syndrome who had the exceptionally rare finding of multivessel giant coronary artery aneurysms (>8 mm) involving the left main and ostial right coronary arteries with concomitant atheroscleroti…
Thrombin Injection for Sealing Epicardial Collateral Perforation During Chronic Total Occlusion Percutaneous Coronary Interventions
Epicardial collateral perforation is a serious complication of retrograde chronic total occlusion percutaneous coronary intervention. We describe two cases of epicardial collateral perforation that were successfully sealed with local thrombin injecti…
Rotational Atherectomy: If You Do Not Do It Before, You Can Do It After Stenting
A case is presented that shows rotational atherectomy can be a useful tool in a compromising situation, such as severely underexpanded implanted stents.
Insights Into Very Late Stent Thrombosis From the Wisdom of Pathology
A thoughtful commentary on the evolution of stent technology and resulting complications, as pertaining to this month’s article by Kaliyadan, et al.
The Efficacy and Safety of the “Hybrid” Approach to Coronary Chronic Total Occlusions: Insights From a Contemporary Multicenter US Registry and Comparison With Prior Studies
Advancements in equipment and the flexibility to switch between multiple technical approaches in a single procedure have dramatically increased the success of CTO-PCI. This study compares contemporary procedural outcomes of hybrid CTO-PCI with previo…
Role of Inflammatory Mediators in the Pathogenesis of Plaque Rupture
This review evaluates the known mediators of local and systemic inflammation implicated in the atherothrombotic process and considers which may be valuable to the clinician now and in the future.
High Femoral Artery Bifurcation Predicts Contralateral High Bifurcation: Implications for Complex Percutaneous Cardiovascular Procedures Requiring Large Caliber and/or Dual Access
Recent technological advances have led to increased use of bilateral femoral artery access and the requirement for large-bore access. Our study examines the relationship between bifurcation level of one CFA and the contralateral CFA in order to bette…
“Very” Very Late Stent Thrombosis: Acute Myocardial Infarction From Drug-Eluting Stent Thrombosis More Than 5 Years After Implantation
A serious long-term complication of drug-eluting stent (DES) implantation is the occurrence of very late stent thrombosis beyond 1 year after implantation. We identified a series of patients who presented with acute myocardial infarction due to stent…
Standardized Methodology for Transfemoral Transcatheter Aortic Valve Replacement With the Edwards Sapien XT Valve Under Fluoroscopy Guidance
Transfemoral transcatheter aortic valve replacement (TAVR) is currently reserved for patients with severe, symptomatic aortic stenosis who are inoperable or at high surgical risk.  We provide a simplified, stepwise guide for transfemoral TAVR with th…