Editor`s Message July 2004

Dear Readers, This issue of The Journal of Invasive Cardiology includes original research articles, expert commentary, case reports, and articles from the journal’s special sections “Clinical Decision Making,” “Acute Coronary Syndromes” and “Clinical Images.” The first original article, submitted by Dr. Francois Gobeil and colleagues from the Departments of Interventional Cardiology at Jacques Cartier Hospital in Massy, France and Notre-Dame Hospital, Montreal University School of Medicine in Montreal, Canada, presents a prospective randomized trial comparing 5-French and 6-French guiding catheters for transradial coronary intervention. They found that intervention with 5-French catheters often required crossover to 6-French catheters and offered no clear advantage over the larger catheter. In the second original research article, Dr. Zoran Lasic and collaborators from the Department of Interventional Cardiology at Lenox Hill Hospital and Cardiovascular Research Institute in New York, New York, compare the safety and efficacy between first and second generation Angio-Seal closure devices used in patients undergoing percutaneous coronary interventional procedures. Their study demonstrated that results were comparable when comparing the two versions of the closure device. Drs. William Alexis and Joseph Carver have provided a commentary for the article. The third research article, submitted by Dr. Ganeshkumar Anne and colleagues from the Division of Invasive Cardiology at the Rambam Medical Center and the Technion-Israel Institute of Technology in Haifa, Israel compares the volume of contrast delivered between the traditional and automated injection contrast system in diagnostic and interventional procedures. They showed that less contrast was required and less was wasted using the automated injection system. In the next original research article, Dr. Deepak Jain and colleagues from the Medizinische Klinik II at the Universitatsklinikum Lubeck describe their subgroup analysis from the RENO registry of the results of intracoronary Beta-Brachytherapy administered with a 60 mm transfer device. They demonstrated that the longer transfer device was safe and effective, offering some advantages in treating long segments of in-stent restenosis. In the last original research article, Dr. Mayra Guerrero and associates from Mount Sinai Hospital, Chicago Medical School in Chicago, Illinois describe their evaluation of patients after successful renal artery stenting. They showed that over 80% survived four years after the procedure, with a majority of the deaths due to cardiac causes. Dr. George Vetrovec from the editorial board has provided a commentary to accompany the Guerrero et al. article. Three of our special clinical sections are featured in this issue of the journal. In the first special section, Clinical Decision Making, edited by Dr. Michael Sketch from Duke University Medical Center in Durham, North Carolina, Drs. Francis Almeda and Jeffrey Snell describe an interesting patient who presented with severe coronary artery disease and cardiogenic shock after prolonged cardiopulmonary resuscitation. Drs. Ramesh Daggubati, Joshua DeLeon, Lloyd Klein and John Webb present their perspectives about the management of this patient. In the next special section, Acute Coronary Syndromes, edited by Dr. Lloyd Klein from the Section of Cardiology, Rush Heart Institute at Rush-Presbyterian-St. Luke’s Medical Center in Chicago Illinois, Dr. Klein has invited Drs. Blaithnead Murtagh and H. Vernon Anderson from the Cardiology Division at the University if Texas Health Science Center in Houston, Texas to provide a review on inflammation and atherosclerosis in acute coronary syndromes. They have submitted a very comprehensive review of this topic. In the next special section, Clinical Images, edited by Dr. David Rizik from the Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona, Drs. Teo, Roberts-Thomson and Worthley present a case demonstrating the utility of intravascular ultrasound in the diagnosis of ambiguous calcific left main stenosis. This issue of the journal also includes several case reports with brief reviews. Dr. Christoph Auf der Maur and associates from the Division of Cardiology, Kantonsspital Luzern in Luzern, Switzerland present a case report and brief review of their therapeutic approach using a polytetrafluoroethylene-covered graft stent for the successful closure of a coronary-pulmonary artery fistula. In the next case report with brief literature review, submitted by St. Jude Medical Angio-Seal Vascular Closure Device STS PLATFORM is indicated for use in closing and reducing time to hemostasis at the femoral arterial puncture site in patients who have undergone diagnostic angiography procedures or interventional procedures using an 8 French or smaller procedural sheath for the 8F ANGIO-SEAL device and a 6 French or smaller procedural sheath for the 6F ANGIO-SEAL device. Do not use the ANGIO-SEAL device where bacterial contamination of the procedure sheath or surrounding tissues may have occurred as this may result in an infection. Do not use the ANGIO-SEAL device if the procedure sheath has been placed through the superficial femoral artery and into the profunda femoris as this may result in collagen deposition into the superficial femoral artery. This may reduce blood flow through the vessel leading to symptoms of distal arterial insufficiency. Do not use the ANGIO-SEAL device if the puncture site is at or distal to the bifurcation of the superficial femoral and profunda femoris artery, as this may result in the 1) anchor catching on the bifurcation or being positioned incorrectly, and/or 2) collagen deposition into the vessel. These events may reduce blood flow through the vessel leading to symptoms of distal arterial insufficiency. Do not use the ANGIO-SEAL device if the puncture site is proximal to the inguinal ligament as this may result in a retroperitoneal hematoma. The safety and effectiveness of the ANGIO-SEAL device has not been established in the following patient populations: patients undergoing an interventional procedure whom are being treated with warfarin, who have known allergies to beef products, collagen and/or collagen products, or polyglycolic or polylactic acid polymers, with pre-existing autoimmune disease, undergoing therapeutic thrombolysis, punctured through a vascular graft, with clinically significant peripheral vascular disease, with uncontrolled hypertension (>180 mm Hg systolic), with a bleeding disorder, including thrombocytopenia (