Aortic pressures within a giant right coronary artery aneurysm.

Background: Giant coronary artery aneurysms are rare conditions with potentially devastating consequences. We report a case of the largest documented giant right coronary artery (RCA) aneurysm to date.

Case Presentation: A 57-year-old male patient visited our outpatient clinic for abdominal pain and exertional dyspnea.

Gender-Related Outcomes in Saphenous Vein Graft Interventions.

Background: Saphenous vein graft percutaneous coronary intervention (SVG-PCI) is a relatively common procedure in patients after coronary artery bypass grafting (CABG). Although internal mammary artery is considered optimal, SVG is still used in the majority of patients.

Aims: Investigating the potential role of gender differences in the incidence and outcomes of SVG-PCI.

Guiding catheter inner lumen damage during percutaneous coronary intervention.

Guiding catheter damage and body wire intermingling are uncommon complications of standard operational procedures. Optimal application of this device includes replacing the small guiding catheter upon excessive resistance during stent insertion.

Impact in total ischemic time and ST-segment elevation myocardial infarction admissions during COVID-19.

Background: Despite the COVID-19 pandemic, cardiovascular disease is still the main cause of death in developed countries. Of these deaths, acute coronary syndromes (ACS) account for a substantial percentage of deaths. Improvement in ACS outcomes, are achieved by reducing the time from symptom onset until reperfusion or total ischemic time (TIT).

A calcified chronic total occlusion preclinical model.

Objective: To create an experimental chronic total occlusion (CTO) model with calcification by dietary modification (cholesterol, calcium carbonate, vitamin D) and local injection of pro-calcification factors (dipotassium phosphate, calcium chloride, and bone morphogenetic protein-2 [BMP-2]).

Background: Percutaneous revascularization of CTOs frequently fails in heavily calcified occlusions. Development of novel approaches requires a reproducible preclinical model of calcified CTO.

Difference in left atrial appendage remodeling between diabetic and nondiabetic patients with atrial fibrillation.

Background: Diabetes mellitus (DM) is a common and increasingly prevalent condition in patients with atrial fibrillation (AFib). The left atrium appendage (LAA), a small outpouch from the LA, is the most common location for thrombus formation in patients with AFib.

Hypothesis: In this study, we examined LAA remodeling differences between diabetic and nondiabetic patients with AFib.

Reduction in operator radiation exposure during transradial coronary procedures using a simple lead rectangle.

Objectives: Transradial access for percutaneous coronary intervention (PCI) reduces procedural complications however, there are concerns regarding the potential for increased exposure to ionizing radiation to the primary operator. We evaluated the efficacy of a lead-attenuator in reducing radiation exposure during transradial PCI.

Methods And Results: This was a non-randomized, prospective, observational study in which 52 consecutive patients were assigned to either standard operator protection (n = 26) or the addition of the lead attenuator across their abdomen/pelvis (n = 26).

Distal coronary embolization following acute myocardial infarction increases early infarct size and late left ventricular wall thinning in a porcine model.

Background: Distal coronary embolization (DCE) of thrombotic material occurs frequently during percutaneous interventions for acute myocardial infarction and can alter coronary flow grades. The significance of DCE on infarct size and myocardial function remains unsettled. The aims of this study were to evaluate the effects of DCE sufficient to cause no-reflow on infarct size, cardiac function and ventricular remodeling in a porcine acute myocardial infarction model.

Site localization of painful lesions during radiofrequency ablation of pulmonary veins using circular multi-electrode catheters.

Purpose: Previous data showed that pain sensation was common during pulmonary vein isolation (PVI) using an 8-mm radiofrequency (RF) ablation catheter. Pain was more common in the left pulmonary veins (PVs). We characterized the location of pain during PVI using circular multi-electrode ablation catheters.

Perlecan heparan sulfate proteoglycan is a critical determinant of angiogenesis in response to mouse hind-limb ischemia.

Background: Perlecan is a heparan sulfate proteoglycan (HSPG) constituent of the extracellular matrix with roles in cell growth, differentiation, and angiogenesis. The role of the HS side chains in regulating in vivo angiogenesis after hind-limb ischemia is unknown.

Methods: Heparan sulfate (HS)-deficient perlecan (Hspg2(Δ3/Δ3)) mice (n = 35), containing normal perlecan core protein but deficient in HS side chains, and wild-type (n = 33) littermates underwent surgical induction of hind-limb ischemia.

Heparan sulfate side chains have a critical role in the inhibitory effects of perlecan on vascular smooth muscle cell response to arterial injury.

Perlecan is a proteoglycan composed of a 470-kDa core protein linked to three heparan sulfate (HS) glycosaminoglycan chains. The intact proteoglycan inhibits the smooth muscle cell (SMC) response to vascular injury. Hspg2(Δ3/Δ3) (MΔ3/Δ3) mice produce a mutant perlecan lacking the HS side chains.

Therapeutic angiogenesis with VEGF164 for facilitation of guidewire crossing in experimental arterial chronic total occlusions.

Aims: Percutaneous revascularisation of chronic total occlusions (CTO) is limited by failure of guidewire crossing. Neovascularisation within the proximal CTO segment may be important for guidewire crossing and dramatically declines in CTO beyond six weeks of age. The aims of the current study were to determine whether local delivery of a pro-angiogenic growth factor increases neovascularisation in mature CTO and facilitates guidewire crossings.

Characterisation of a novel porcine coronary artery CTO model.

Aims: To create a large animal coronary chronic total occlusion (CTO) model. Presence of microvessels within the CTO lumen facilitates guidewire crossing. The patterns and time profiles of matrix changes and microvessel formation during coronary CTO maturation are unknown.

Statin therapy prevents expansive remodeling in venous bypass grafts.

Background: Venous grafts (VG) have high failure rates by 10 years in aortocoronary bypass surgery. We have previously shown that expansive remodeling followed by increased LDL retention are early atherosclerotic changes in experimental VG placed in the arterial circulation. The objective of this study was to determine whether statin therapy prevents these expansive remodeling changes.

Clopidogrel Therapy Discontinuation Following Drug Eluting Stent Implantation in Real World Practice in Israel.

Background: Incidence and predictors of clopidogrel discontinuation after drug eluting stent (DES) implantation, in real world practice, are poorly known.

Methods: Prospective study included all patients who underwent implantation of at least one DES between February 2006 and January 2007. Predictors of clopidogrel discontinuation were assessed by a multivariable analysis.

Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry.

Objectives: The purpose of this study was to determine the prevalence, clinical characteristics, and management of coronary chronic total occlusions (CTOs) in current practice.

Background: There is little evidence in contemporary literature concerning the prevalence, clinical characteristics, and treatment decisions regarding patients who have coronary CTOs identified during coronary angiography.

Methods: Consecutive patients undergoing nonurgent coronary angiography with CTO were prospectively identified at 3 Canadian sites from April 2008 to July 2009.

Collagenase Total Occlusion-1 (CTO-1) trial: a phase I, dose-escalation, safety study.

Background: Percutaneous interventions for chronic total occlusions have low success rates, primarily because of failure of guide wire crossing. Collagen-rich matrix constitutes the main barrier to chronic total occlusion crossing. In preclinical studies, local delivery of a bacterial collagenase formulation improved guide wire crossing.

Decreased risk of stent fracture-related restenosis between paclitaxel-eluting stents and sirolimus eluting stents: results of long-term follow-up.

Objective: To compare the outcomes between paclitaxel-eluting stents (PES) and sirolimus-eluting stents (SES) for the treatment of drug-eluting stent (DES) fracture.

Background: DES fracture is considered as an important predictor of in-stent restenosis (ISR). However, little data are available evaluating the optimal treatment for this complication of coronary stenting.