May-06

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, commentaries, a review, a CME offering and articles from the journal’s special sections Clinical Decision Making and Clinical Images. In addition, there are six case reports that are published as part of this issue of the journal on our web site (www.invasivecardiology.com). I encourage you to visit the web site to read these interesting and informative case reports. The first research article, submitted by Dr. Yasunori Ueda and associates from the Osaka Police Hospital in Osaka, Japan, presents research in which the authors studied differences in plaque composition through angioscopic evaluation of patients presenting with ACS with and without CK elevation. They found that angioscopically-determined extent of coronary atherosclerosis was more advanced in ACS patients with CK elevation compared to those without CK elevation. In the next original article, Dr. Shyam Bhakta and collaborators from Case Western Reserve University in Cleveland, Ohio, describe their research to determine the safety of autologous intracoronary stem cell injections in a porcine model of chronic myocardial ischemia. Animal studies such as this one provide information that is critical to implementing these techniques in humans. Dr. Eberhard Grube and colleagues from the Heart Center Siegburg in Siegburg, Germany, present their research to evaluate a new polymer-coated paclitaxel-eluting stent for treatment of de novo lesions with 6-month clinical and angiographic follow-up results of the APPLAUSE Trial. In this small randomized study they were able to demonstrate that the new paclitaxel-eluting stent was safe, and at 6-month angiographic analysis, demonstrated reduced binary restenosis, less in-stent late loss and in-segment late loss compared to patients with bare metal stents. In the next original research paper, Dr. John Webb and associates from St. Paul’s Hospital in Vancouver and Duke University, describe their initial experience using a novel coronary rinsing and thrombectomy system called “rinspiration”. Their results are encouraging, showing that the device is able to safely remove intracoronary thrombus with acceptable outcomes at 30 days. Drs. Mohammad-Reza Movahed and Curtiss Stinis from the University of California, Irvine Medical Center in Irvine, California, present a new, simplified classification system for describing coronary bifurcation lesions and bifurcation interventional techniques. Using a series of easy to remember letters and numbers, they have created a clinically relevant anatomic description that can be applied to coronary artery bifurcation lesions. In the last original research article, Dr. Jae-Sik Jang and collaborators from the Asan Medical Center, University of Ulsan College of Medicine in Seoul, South Korea, present their study comparing sirolimus- and paclitaxel-eluting stents for the treatment of total occlusions. There were no significant differences in initial in-hospital results, but there was a higher rate of restenosis in the paclitaxel-eluting stent patients at 6-month angiographic follow up. Dr. H. Vernon Anderson of the editorial board has provided a commentary to accompany the Jang et al. article. Two of our special sections are featured in this issue of the journal. In the first special section, Clinical Images, edited by Dr. David Rizik from Scottsdale Heart Group, Dr. Matthew Worthley from the Department of Cardiovascular Sciences at the University of Calgary in Calgary, Alberta, Canada, presents a case using IVUS to show disruption of in-stent neo-intima causing acute myocardial infarction. In the Clinical Decision Making section, edited by Dr. Michael Sketch from Duke University, Dr. Hidehiko Hara and colleagues from Toho University Ohashi Hospital in Tokyo, present a case of hypertrophic obstructive cardiomyopathy complicated by a single coronary artery treated by transcoronary septal ablation. Drs. Blase Carabello, Paul Sorajja and Andrew Wang have provided additional treatment scenarios and commentaries as part of the clinical decision making discussion. This issue of the journal also includes six excellent case reports that can be found online. In the first of these, Drs. Jeffrey Hershey, Loretta Isada and Michael Fenster from the AGMC Heart and Vascular Center in Akron, Ohio, present a case of emergent primary PCI of an anomalous LAD artery. In the second case report, Dr. David Dobies and colleague Amanda Cohoon, RN, from the Genesys Regional Medical Center in Grand Blanc, Michigan, describe a case that demonstrates their technique of injecting lubricant into the guiding catheter to enable easier stent deployment. In the next online case report, Dr. Woong Chol Kang and associates from Gil Heart Center in Incheon, South Korea, describe a case using successful PCI for severe stenosis of an anomalous left coronary artery originating from the proximal right coronary artery. In the next case report, Dr. Raed Aqel and colleagues from the University of Alabama at Birmingham, describe a case involving systolic compression of bypass grafts. Dr. Peiman Jamshidi and associates from Kantonal Hospital in Luzern, Switzerland, present a case in which they performed percutaneous aspiration of an inferior vena cava thrombus. In the last case report, Drs. Movahed, Amani and Stinis, from the University of California Irvine Medical Center, present two cases of combined peripheral and coronary artery percutaneous intervention where patients had significant coronary and peripheral vascular disease. This issue also includes a special CME offering. Drs. Gianluca Rigatelli and Ziyad Hijazi have provided a comprehensive discussion of intracardiac echocardiography in cardiovascular catheter-based interventions, demonstrating that there are different devices for different purposes. I encourage you to read this article and participate in the CME activity. This issue of the journal is completed with a review provided by Dr. William Hau on the routine use of pressure-derived fractional flow reserve guidance as it has evolved from a diagnostic modality to everyday practice. It is my hope that each of the articles in this issue of the journal provides cardiovascular healthcare professionals with information that improves the daily care of cardiac patients. Sincerely, Richard E. Shaw, PhD, FACC, FACA Editor-in-Chief