Editor`s Message August 2004

This issue of The Journal of Invasive Cardiology includes original research articles, commentary, case reports, and articles from the journal’s special sections Intervention in Peripheral Vascular Disease and Clinical Decision Making. In the first original research article, Dr. Manuel Jiménez-Navarro and colleagues from the Hospital Clinico Virgen de la Victoria present a study designed to determine whether patients with moderately severe stenosis of the left main coronary artery and negative FFR results should be treated. They conclude that FFR does provide useful information that may be helpful in the treatment decision-making process. Dr. Stephen Ellis of the Cleveland Clinic Foundation has provided a commentary on this extremely important issue, where as he states, “This is not a place to make a mistake.” In the next original research article, Dr. Peter den Heijer from Amphia Ziekehuis, along with collaborators from St. Antonius Hospital and the ThoraxCenter in The Netherlands, present the results of the RESTOR trial which assesses the safety and efficacy of a new coronary stent, the R-stent. The study demonstrates good results with this stent which utilizes a dual helix design for radial strength and flexibility, and suggests that this stent platform may be well suited for developing a drug-eluting stent. Dr. Seung-Whan Lee and associates from the Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center in Seoul, Korea, present their study comparing the use of rotational atherectomy plus stenting with rotational atherectomy plus balloon angioplasty in complex lesions. In analysis of early and late results, they found no difference between these approaches to the treatment of complex lesions. Drs. David Ramsdale and Nick Palmer from the Cardiothoracic Centre in Liverpool, United Kingdom have written a commentary to accompany the Lee et al. article that delves further into the issues involved in using rota-stenting in long, complex coronary lesions. Next, Dr. Kean-Wah Lau and collaborators, from the National Heart Centre in Singapore, provide a review of the current status of stent treatment used in small (Clinical Decision Making, Drs. Halabi, Sketch and Zidar from the Duke University Medical Center present a challenging case for clinical decision-making involving the treatment of a patient with a bifurcation lesion. Dr. William O’Neill from William Beaumont Hospital in Royal Oak, Michigan, Dr. Howard Herrmann from the University of Pennsylvania Medical Center in Philadelphia, Pennsylvania, and Dr. Jeffrey Werner from Mercy Health Systems of Northwest Arkansas, have all offered their own perspectives on the therapeutic approach to this difficult case. In the Interventions in Peripheral Vascular Disease special section of the journal, edited by Dr. Frank Criado of the Division of Vascular Surgery at the Union Memorial Hospital /Medstar Health in Baltimore, Maryland, Dr. Nicolas Shammas from the Genesis Heart Institute in Davenport, Iowa has provided an excellent overview of the use of antithrombins in peripheral vascular intervention. 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.