Editor’s Message - March 2002

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, commentaries, case reports, an article from the Journal special section “Acute Coronary Syndromes,” a special CME offering and an interview with Dr. Frank Criado. The research articles in this issue cover a broad range of topics that touch on important aspects of patient care. In the first research article, Drs. Paul Teirstein and John Reilly of the Scripps Clinic in La Jolla, California discuss the problem of late stent thrombosis following brachytherapy. They indicate that patients who receive a new stent at the time of brachytherapy and patients in whom antiplatelet therapy is discontinued are at much higher risk for developing late stent thrombosis, and clinicians must consider this in developing strategies to for the long-term management of these patients. Dr. Dean Kereiakes and colleagues from the Lindner Center for Research and Education/Ohio Heart Health Center in Cincinnati, Ohio provide further elaboration on the treatment of patients following the use of brachytherapy and illustrate these points with several instructive case reports and a discussion of the need for even more aggressive long-term use of antiplatelet therapies in these patients. In the second original research article, Dr. Yilmaz Nisanci and colleagues of the Department of Cardiology at Istanbul University in Istanbul, Turkey have submitted their work studying the relationship between pressure derived collateral blood flow and diabetes mellitus in patients presenting with stable angina pectoris. The researchers show that their newly developed technique of intracoronary pressure measurement demonstrates that diabetics have impaired coronary collateral development compared to non-diabetics. In an accompanying editorial commentary, Drs. S.K. Chugh and John Webb from St. Paul’s Hospital in Vancouver, British Columbia, Canada review the limitations of angiographic assessment of collateral flow and stress the importance of new techniques to accomplish this, which has significant clinical utility in the treatment of diabetics and other patients where it is crucial to preserve myocardial viability. In the third original research report, also from the Department of Cardiology at Istanbul University in Istanbul, Turkey, Dr. Berrin Umman and colleagues describe their research investigating the relationship between improvement of the corrected TIMI frame count and change in myocardial fractional flow reserve assessed in the infarct related artery in patients with recent myocardial infarction who had percutaneous coronary intervention. Their study demonstrates that revascularization results in a decrease in corrected TIMI frame count in proportion to increase in fractional flow reserve in the infarct related artery of recent MI patients, providing useful information to evaluate the outcome of treatment in these patients. This issue of the Journal includes two interesting case reports on innovations in the treatment of non-cardiac organ systems using catheter-based techniques. In the first report, Dr. Sven Braunlich and collaborators from the departments of Cardiology and Nephrology at the University of Erlangen-Nuremberg in Erlangen, Germany and the Department of Vascular Medicine at the Cleveland Clinic Foundation describe their use of the radial approach to perform renal artery angioplasty and stenting to treat severe renal artery disease. This approach could enable more widespread use of outpatient treatment for this condition, significantly reducing healthcare costs. In the second report, Drs. Ashok Dhar and D. Anklesaria describe their evaluation and successful treatment using transcatheter techniques of a traumatic common hepatic artery aneurysm in a patient who was at high risk for surgical intervention. This issue also has an article from our newest 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. Amr El-Shafei and Morton Kern of the Saint Louis University Health Services Center in St. Louis, Missouri to provide a review of new techniques that are emerging for the evaluation of the vulnerable plaque. This excellent paper includes a comprehensive summary of available techniques and discusses new approaches currently in development. In our continuing effort to better address the needs of our readership, an article has been included in this issue for Continuing Medical Education (CME) credits. Dr. Neeraj Prasad of the Department of Cardiology at the City Hospital NHS Trust in Birmingham, United Kingdom and Dr. Peter Seidelin of the Division of Cardiology at the Toronto Hospital in Toronto, Ontario, Canada have provided an overview of the occurrence and treatment of side branch compromise during percutaneous coronary interventions. Please follow the instructions provided to receive CME credit for this article. This issue is completed with an interview conducted by Laurie Gustafson with Dr. Frank Criado, a member of the editorial board of the Journal of Invasive Cardiology and editor of the Journal special section on peripheral vascular intervention. The interview reveals some of the unique turns that occurred and the important milestones in the career of Dr. Criado, an insight into his personal life and his thoughts about the future of vascular treatment. It is my hope that all of the articles in this issue of the journal provide information that is timely and useful for all professionals involved in the delivery of health care to cardiac patients.