Editor`s Message (January 2003)

Dear Readers, This issue of the Journal of Invasive Cardiology begins another exciting year for the publication of the Journal and includes original research articles, case reports, reviews, articles from the Journal special sections “The Electrophysiology Corner” and “Interventional Pediatric Cardiology”, and a summary of the discussion on intracranial intervention from the International Andreas Gruentzig Society Meeting held in February of 2002. The first research article, by Dr. Flavio Airoldi and collaborators from the multi-center Crosscut Study representing seven Italian centers, presents results from this randomized trial comparing direct stenting versus stenting with predilatation in native coronary artery disease. They demonstrated that similar results were achieved with direct stenting compared to stenting with predilatation, but there was a significant reduction in procedural cost for direct stenting. In the second original research article, Drs. Wolfgang Schöbel and Manfred Mauser from the departments of Cardiology at University of Tubingen in Tubingen, Germany and Klinikum Lahr in Lahr, Germany describe their experience using 5 French guiding catheters for percutaneous coronary intervention in 1200 consecutive patients. They achieved a 92% success rate, with more complex lesion morphology associated with a lower success rate. Dr. Bernhard Meier from the Swiss Cardiovascular Center Bern in Bern, Switzerland has written an editorial commentary and provides a further discussion of the advantages of moving to this smaller technology. The third research article, submitted by Drs. Dongming Hou and Keith March from the Krannert Institute of Cardiology, Indiana University School of Medicine and the Richard L. Roudebush Veterans Administrative Medical Center in Indianapolis, Indiana, describes their animal research on a new device to safely gain pericardial access to obtain diagnostic sampling of pericardial fluids and delivery of therapeutic agents. In the last original research article, Dr. Ioannis Iakovou and collaborators from the Cardiovascular Research Foundation, Lennox Hill Heart and Vascular Institute in New York and the Washington Hospital Center in Washington, D.C. present their study on the impact of gender on the incidence and outcome of contrast-induced nephropathy after percutaneous coronary intervention. They found that female gender was a significant predictor of contrast induced nephropathy and worse 1-year mortality in patients who did not have chronic renal failure at baseline. Dr. Abdallah Rebeiz and colleagues from Duke University Medical Center have provided an excellent and thorough discussion of the research in this area and the article by Iakovou et al. They conclude that one of the major problems is the definition of renal dysfunction used that is based solely on serum creatinine level, and they suggest moving to the use of creatinine clearance as a more reliable indicator of renal function. This issue of the Journal also includes case reports on interesting topics as well as two case reports with brief reviews of the literature. In the first case report and brief review, Dr. C.G. Bahuleyan and colleagues from the Department of Cardiology at the Medical College Hospital, Thiruvananthapuram in Kerala State, India, demonstrates the utility of the Rescue Percutaneous Thrombectomy Catheter in successfully removing extensive clot in a patient following acute myocardial infarction. The second case report and brief review, submitted by Drs. Battikh, Rihani and Lemahieu describe their use of double stenting in a patient who had treatment of the left main coronary artery with a stent that acutely recoiled. In the first case report, Dr. Man Hong Jim and colleagues from the Department of Medicine at Queen Mary Hospital in Hong Kong describe their management of a difficult bifurcation lesion with a subtotal occlusive lesion using a triple wire technique. In the next case report, Drs. Sunami, Saito and Tanaka from the Division of Cardiology and Catheterization Laboratories at the Heart Center of ShonanKamkura General Hospital in Kamakura City, Japan describe their treatment of a patient with an anomalous coronary artery using a self-expanding stent via the radial approach. The final case report, submitted by Drs. Ramamurthy, Talwar and Sharma from the Departments of Cardiology and Cardiac Radiology at the All India Institute of Medical Sciences in New Delhi, India, demonstrated their approach using multiple stents to treat a dissection of the thoracic aorta that resulted from balloon dilatation. Two of our special clinical sections are featured in this issue. The first special section, which covers advances in the field of Interventional Pediatric Cardiology and is edited by Dr. P. Syamasundar Rao from the Division of Pediatric Cardiology at Saint Louis University School of Medicine in St. Louis, Missouri, includes an article from Dr. Chi-hang Lee and colleagues from the Department of Cardiology Grantham Hospital, the Department of Nuclear Medicine at Queen Mary Hospital and Department of Medicine at Yan Chai Hospital in Hong Kong. Their article describes transcatheter closure of the patent ductus arteriosus that is often treated in pediatric patients, but poses challenges when the intervention is done on adults. In the last special journal section, the Electrophysiology Corner, edited by Dr. Todd Cohen of the Department of Cardiology at Winthrop-University Hospital in Mineola, New York, Dr. Cohen has collaborated with associates from the Divisions of Cardiology and Neurology, and the Department of Medicine at Winthrop to present an analysis of the prognostic value of QT dispersion in patients presenting with acute neurological events. This issue is completed with a transcript of the discussion on the current state of intracranial interventions that occurred at the International Andreas Gruentzig Society meeting held in St. Lucia in February of last year. This discussion highlights the fact that acute interventions for stroke and the use of intracranial stenting are areas of treatment that are in their infancy, but are evolving as important areas of multidisciplinary collaboration. The discussion draws many parallels with the development that has gone on in cardiology over the years that has moved the treatment of acute coronary syndromes from an inactive management of the patient to exciting and aggressive therapeutic approaches. This evolution will undoubtedly revolutionize the treatment of strokes It is my hope that all of the articles in this issue of the journal provide cardiologists, vascular interventionists, neurologists and radiologists with valuable information that is useful in collaborating to improve the care of patients with cardiovascular disease.