Unconventional treatment of a giant coronary aneurysm presenting as ST-elevation myocardial infarction: a case report.

Background: The optimal treatment of aneurysmal or ectatic culprit vessels in the setting of acute myocardial infarction is still matter of debate, as revascularization with either percutaneous intervention or surgery is associated with low procedural success and poor outcomes.

Case Summary: We report the case of a 55-year-old male patient, admitted for inferior ST-elevation myocardial infarction, who underwent successful percutaneous implantation of a micro-mesh self-expanding nitinol carotid stent in a right coronary aneurysm with intravascular ultrasonography measured diameter of 9 mm and massive thrombus apposition.

Discussion: The technical characteristics of the micro-mesh self-expanding nitinol carotid stent allow for adequate plaque coverage and good apposition even in large vessels, making this device particularly suitable for the treatment of coronary lesions with high thrombus burden, when severe coronary ectasia or aneurysms are present.

[Endovascular treatment of a celiac trunk aneurysm: a case report and review of the literature].

Celiac trunk aneurysms are uncommon vascular lesions; treatment is usually an open surgical operation; in the medical literature, only few cases of celiac aneurysm treated with endovascular technique are reported; coil positioning or stent-graft placement are described using a femoral vascular access as first choice.Here we describe the case of a 57-year-old man with an asymptomatic large celiac trunk aneurysm involving the origin of the splenic, left gastric and hepatic arteries. The patient was treated in an elective clinical setting with a totally endovascular procedure performed through the left radial artery.

Left innominate vein aneurysm finding during pacemaker lead insertion.

Thoracic vein aneurysms are very rare vascular lesions, usually detected as incidental findings. We describe the case of a patient with an advanced atrioventricular block who underwent definitive pacemaker implantation. In order to explain the difficult advancement of a pacemaker lead, vein angiography was performed during the procedure and a large innominate vein aneurysm was observed.

Autonomic modulation of the sinus node following electrical cardioversion of persistent atrial fibrillation: relation with early recurrence.

Background: The aim of this study was to correlate early atrial fibrillation (AF) relapses with heart rate variability (HRV) parameters immediately recorded after electrical cardioversion (EC) of persistent AF.

Methods And Results: We performed the spectral analysis of short-term HRV 30 min after EC in 25 patients with persistent AF. The numbers of patients who maintained sinus rhythm at 48 h, 7, and 30 days were 22, 16, and 14, respectively.

[Circumferential isolation of pulmonary veins with transcatheter radiofrequency ablation in the treatment of atrial fibrillation].

Background: Circumferential anatomical isolation of the pulmonary veins by radiofrequency transcatheter ablation is a new technique for the treatment of atrial fibrillation (AF). The aim of our study was to evaluate the efficacy and the safety of circumferential radiofrequency ablation of the pulmonary veins and to analyze clinical, echocardiographic and procedural parameters as possible predictors of clinical success.

Methods: We performed circumferential isolation of the pulmonary veins in 33 patients with paroxysmal (15 patients) or persistent AF (18 patients) refractory to at least two antiarrhythmic drugs.

Variables correlated with early relapses after external electrical cardioversion of persistent atrial fibrillation.

Background: The aim of this study was to identify the clinical and echocardiographic variables possibly correlated with the early relapses of atrial fibrillation (AF) after external electrical cardioversion (EC) in a large cohort of patients with persistent AF.

Methods: Two hundred patients (117 males, 83 females, mean age 67.9 +/- 8.

Percutaneous endovascular stent-graft placement for the treatment of acute rupture of an aneurysm of the thoracic aorta.

A 68-year-old male patient presented with massive hematemesis following the acute rupture of an aneurysm of the descending thoracic aorta into the esophagus. In view of the important cardiac and pulmonary comorbidities, surgical treatment was excluded and successful percutaneous implantation of an endovascular stent-graft in the descending aorta was performed. In selected patients endovascular treatment may constitute an alternative to the surgical repair of ruptured aortic aneurysms.