PubMed · 15103607
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Robert M Schainfeld. 2004. Hath David once again slayed Goliath?. https://doi.org/10.1002/ccd.20037
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Vascular inflammation, particularly aortitis, is a known rare manifestation of ankylosing spondylitis. This condition has not been reported to date in the coronary circulation. We present the first documented case of a coronary aneurysm in a patient with ankylosing spondylitis. This association may limit treatment options in such patients, as newer drug-eluting stents may potentiate degeneration in established aneurysmal coronary arteries.
Cerebral emboli and abscesses are common complications in patients with cyanotic congenital heart disease and right-to-left shunt. Of those, a persistent left superior vena cava (LSVC) draining into the left atrium, directly or through an unroofed coronary sinus, is a rather rare finding. In order to prevent recurrent cerebral emboli and abscesses, correction of this anomaly may be recommended. We report the first case of a patient who underwent a percutaneous closure of a persistent LSVC draining into the left atrium with an Amplatzer ASD occluder.
Late luminal loss after percutaneous coronary intervention, although not normally distributed, has been shown to be monotonically correlated with the probability of binary angiographic restenosis after drug-eluting stent implantation. A recently proposed method has been shown to predict the restenosis rate after sirolimus-eluting stent and paclitaxel-eluting stent implantation using a power transformation of the value of late loss obtained after implantation of the 2 stent types. We used the same method to compute and compare restenosis rates from late loss values observed in the "head-to-head" randomized sirolimus-eluting stent versus paclitaxel-eluting stent comparisons available thus far. Our results showed that the model proposed has a poor overall ability to predict the real incidence and relative risk of restenosis because the use of late loss as an end point tended to overestimate the difference in restenosis, and the derived effect estimate of 1 stent compared with that of the other seemed to be overemphasized with respect to the real risk. We thus believe that further investigations are needed to appraise the real clinical effect of late loss and its reliability as an end point in direct comparative drug-eluting stent trials before its use can be recommended as a clinical surrogate.