Clinical outcomes of patients treated with the cutting balloon and Sr-90 beta-irradiation for instent restenosis.

Background: The cutting balloon (CB) is an emerging therapy for the treatment of instent restenosis (ISR), but its impact on the clinical outcomes of patients treated with intracoronary radiation therapy (IRT) with Sr-90 compared with conventional PTCA and IRT is not clearly defined.

Methods: We compared the baseline demographics, angiographic characteristics and clinical outcomes of 102 consecutive patients with ISR treated either with CB+IRT (n=45) or with conventional PTCA+IRT (n=57). The combined endpoint was the occurrence of major adverse cardiac events (MACE), which was defined as a composite of death, myocardial infarction (MI) or target vessel revascularization (TVR) at 6 months.

Report of an undeployed stent causing the unraveling of a coronary artery guidewire being used for sidebranch protection.

We report a case of a 70-year-old male who was undergoing elective angioplasty of the left anterior descending coronary artery. During the procedure, a coronary guidewire became unraveled after positioning an undeployed stent; we describe its successful retrieval by removal of the undeployed stent. Although sidebranch protection and placement of a stent with the guidewire left in place is commonly performed without complication, it should be realized that this practice is not without hazard because of the unusual, but serious consequences that could ensue if the entrapped wire were to unravel.