A case of IgG4-related lymphadenopathy, pericarditis, coronary artery periarteritis and luminal stenosis.

Immunoglobulin G4 (IgG4)-related disease is an emerging new clinicopathological disorder that is characterized by elevation of serum IgG4 levels and histological findings of IgG4-positive plasmacytic infiltration. IgG4-related disease may appear synchronously or metachronously in a wide variety of organs. The current patient was found to have pericardial effusion and retroperitoneal fibrosis.

Plasma Pentraxin3 Level Is Associated With Plaque Vulnerability Assessed by Optical Coherence Tomography in Patients With Coronary Artery Disease.

The role of pentraxin 3 (PTX3) has been implicated in the process of plaque vulnerability. However, few studies have addressed the direct relationship between plaque morphology and plasma PTX3. We evaluated the relationship between coronary vulnerable plaque, assessed by optical coherence tomography (OCT), and plasma PTX3 in patients with coronary artery disease (CAD).

Cardiac metastasis of uterine cervical squamous cell carcinoma: A case report and review of the literature.

A 48-year-old woman was referred to the cardiology department due to a large mobile mass in the right ventricle. The patient had undergone radical hysterectomy and bilateral salpingo-oophorectomy for a uterine squamous cell carcinoma approximately 3.5 years before.

A patient with primary pericardial synovial sarcoma who presented with cardiac tamponade: a case report and review of the literature.

A 36-year-old man presented with near-syncope. He was found to have massive pericardial effusion with a giant pericardial tumorous lesion. The pericardial effusion exhibited a bloody nature; however, neither malignant cells nor infectious organisms were detected.

Immunoglobulin G4-related coronary periarteritis in a patient presenting with myocardial ischemia.

Recent studies suggest that the cardiovascular system might be a possible target of immunoglobulin G4-related disease. Here we present a 66-year-old man who was admitted to our hospital because of chest symptoms suggestive of acute coronary syndrome. Besides luminal narrowing of the coronary arteries, marked periarterial thickening around the coronary artery was observed by computed tomography coronary angiography.

A surgical case of excision of infected aneurysm arising from anterior interosseal artery following infectious endocarditis.

Infected aneurysm (IA) of the anterior interosseal artery (AIA), the first branch of the ulnar artery, is an infrequent but serious complication of infectious endocarditis (IE). We report a successful case of excision of IA arising from AIA. In this case, the IA expanded and adhered to the ulnar artery, resulting in occlusion of the ulnar artery.

Quantitative analysis of intracoronary optical coherence tomography measurements of stent strut apposition and tissue coverage.

Background: The introduction of optical coherence tomography (OCT) as an intracoronary imaging modality has allowed accurate assessment of strut apposition and neointimal tissue coverage. This study set out to assess the inter and intraobserver variability of measurements of acute stent apposition and strut tissue coverage using OCT.

Methods: Thirty patients were studied (14 immediately after stent implantation and 16 during follow-up angiography [mean of 4.

The influence of strut thickness and cell design on immediate apposition of drug-eluting stents assessed by optical coherence tomography.

Background: Stent strut malapposition correlates with poor intimal coverage and this may increase the risk of late stent thrombosis. At present, there is limited data on whether stent strut thickness and stent design impact on acute apposition. We aimed to investigate the influence of stent strut thickness and design on acute stent strut apposition (SSA) immediately following drug-eluting stent (DES) implantation using optical coherence tomography (OCT), a technique with higher resolution and fewer artefacts than intravascular ultrasound.

An indeterminate occlusion duration predicts procedural failure in the recanalization of coronary chronic total occlusions.

Objectives: To identify the impact of occlusion duration (OD) and, in particular, an indeterminate occlusion duration (IOD) on immediate angiographic success and long-term clinical outcomes in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Methods: From May 2003 to October 2006, all patients having PCI for a CTO were consecutively registered. In addition to an assessment of procedural outcomes, patients were followed long-term for occurrence of major adverse cardiac events (MACE).

Optical coherence tomography to assess malapposition in overlapping drug-eluting stents.

Aims: Overlapping drug-eluting stents (DES) are frequently implanted to cover long segments of diseased and injured vessel, or as a bailout technique for edge dissection or incomplete lesion coverage. DES overlap is, nevertheless, associated with strut malapposition and poor intimal coverage, which may increase the risk of stent thrombosis. The aim of this study is to evaluate stent strut apposition in overlapping DES.

Unconventional treatment of aorto-ostial instent restenosis with marked protrusion into the aorta.

We report a case of restenosis following ostial stenting of the right coronary artery, with protrusion of the stent into the aorta. Despite multiple attempts, no wire could be advanced coaxially inside the stent. The solution was to pass a wire through the struts of the protruding stent and crush it using progressively larger balloons and, finally, a drug-eluting stent was expanded to high pressure.

Heavily calcified coronary lesions preclude strut apposition despite high pressure balloon dilatation and rotational atherectomy: in-vivo demonstration with optical coherence tomography.

Heavily calcified lesions (HCL) continue to present challenges that are not always solved by modern low-profile, non-compliant high-pressure balloons, or bladed balloons. Uncrossable or unexpandable lesions need lesion modification, using ablating devices such as rotational atherectomy. Three cases of HCL treated with drug-eluting stents, using a new intravascular imaging device, Optical Coherence Tomography with 10-fold superior resolution and fewer artifacts compared with conventional intravascular ultrasound, are presented.

Retrograde approach to coronary chronic total occlusions: preliminary single European centre experience.

Aims: The retrograde approach via septal or epicardial collaterals holds promise in improving the success rate of chronic total occlusion (CTO) recanalisation but is still viewed as an esoteric practice reserved to a selected group of operators using materials not available in Western countries. We sought to introduce the novel technique of retrograde CTO recanalisation to our institution using materials and resources available outside Japan.

Methods And Results: Between April 2005 and 2007, all patients with a failed antegrade attempt at CTO recanalisation were considered and selected based on their appropriateness to have a retrograde procedure.

Culotte versus T-stenting in bifurcation lesions: immediate clinical and angiographic results and midterm clinical follow-up.

Background: Stenting the main vessel with provisional stenting of the side branch (SB) is the method of choice for most bifurcation lesions. There is limited data on which of the two techniques of bifurcation stenting compatible with a provisional approach, culotte or T-stenting, offers the best outcome.

Methods: Between February 2004 and October 2005, 80 consecutive patients with bifurcation lesions requiring a second stent on the SB were treated with either culotte (n = 45) or T-stenting (n = 35).

Successful crossing of an angulated lesion using a new deflectable-tip guidewire (Steer-IT).

Tortuous or highly angulated vessels can sometimes be a hindrance to successful percutaneous coronary intervention while conferring an increased risk of major adverse events compared to lesions in nonangulated vessels. We present a case demonstrating the benefit of a recently available deflecting tip 0.014 inch guidewire to help negotiate an acute-angled takeoff of the left anterior descending artery from the left main coronary artery.

Intravascular optical coherence tomography: optimisation of image acquisition and quantitative assessment of stent strut apposition.

Stent expansion, apposition and symmetry were the three criteria of intravascular ultrasound (IVUS) guided optimal stent deployment in the bare metal stent era1, with at least the criterion of stent expansion maintaining its clinical relevance in the drug-eluting stent (DES) era2. Two prospective studies showed that stent malapposition immediately following DES implantation was not associated with increased adverse clinical events3,4. Thus, initial concerns that immediate stent malapposition would affect drug delivery to the vessel wall and lead to DES failure appeared to be unfounded.