[Unusual thrombus embolization during primary coronary angioplasty: a case report].

Embolization of thrombotic material during primary angioplasty may occur even if the procedure is performed with appropriate medication as well as in hospital centers having a high volume of procedures. Over recent years the introduction of mechanical devices for thromboaspiration and/or distal protection have reduced the incidence of embolization thus improving myocardial reperfusion and survival. We report the case of a large thrombus migrated from the proximal left circumflex artery to the proximal left anterior descending artery during balloon inflation.

Feasibility and long-term safety of elective Impella-assisted high-risk percutaneous coronary intervention: a pilot two-centre study.

Objective: We evaluated the acute and long-term results of the use of a new intracardiac microaxial pump, the Impella Recover LP 2.5, during elective high-risk percutaneous coronary interventions in a two-centre registry.

Methods: Ten consecutive patients with poor left ventricular function and multivessel or left main coronary artery disease were considered at high risk of haemodynamic compromise and underwent percutaneous coronary interventions with preintervention Impella implantation.

An innocent bystander: a case of unstable angina.

We describe an usual case of unstable angina, with an unusual presentation, trying to demonstrate the importance to listen to our patients and their symptoms.

Outcomes of the tacrolimus drug-eluting Janus stent: a prospective two-centre registry in high-risk patients.

Background: To date, only two drug-eluting stents (DES) have been extensively tested in both randomized controlled clinical trials and large 'real world' registries: sirolimus-DES (Cypher stent, Cordis, Miami Lakes, Florida, USA) and paclitaxel-DES (Taxus stent, Boston Scientific, Natick, Massachusetts, USA). Recently, a new polymer-free tacrolimus-eluting Carbofilm-coated stent, the Janus stent (Sorin Biomedica, Saluggia, Italy), has entered the market but only few clinical data testing its safety and efficacy in selected patients are available. Thus, we performed a prospective registry of consecutive, unselected patients receiving this new DES.

Repair of acute postinfarct posterior ventricular septal rupture without left ventriculotomy: a stable suture preserving left ventricular geometry.

The present article describes the case of a man operated upon for emergency closure of an acute postinfarction defect in the posterior septum. We used a novel technique. The rupture was approached by disconnection of the right ventricular posterior free wall with the exposure of the right side of the septum.

Preprocedural level of soluble CD40L is predictive of enhanced inflammatory response and restenosis after coronary angioplasty.

Background: Inflammation plays a pathogenic role in the development of restenosis after percutaneous transluminal coronary angioplasty (PTCA). CD40-CD40L interaction is involved in the pathogenesis of atherosclerosis; however, its role in the pathophysiology of restenosis is still unclear. We tested the hypothesis that soluble CD40L (sCD40L) may be involved in the process of restenosis and that it exerts its effect by triggering a complex group of inflammatory reactions on endothelial and mononuclear cells.