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The recognition of woven coronary artery anomaly is difficult because of its rare nature. Optical coherence tomography imaging is challenging due to the tortuosity of the channels; however, it is crucial not only for the differential diagnosis but also to guide the treatment approach.

Risk awareness of no-reflow is mandatory, especially in patients with cardiovascular risk factors, long door-to-balloon time, and in the presence of angiographic evidence of a large thrombus burden. Some preventive strategies have been described. Nevertheless, in clinical practice, is difficult to avoid no-reflow. Interventional cardiologists have no guidelines or recommendations for this situation. We suggest that a conservative management with dual antiplatelet therapy and slow intravenous infusion of nitroglycerine over 12 to 24 hours and abciximab, followed by deferred [...]

A 50-year-old man with an inferior myocardial infarction was admitted after successful fibrinolysis. Coronary angiography showed 2 giant coronary aneurysms in series in the right coronary artery with high thrombus burden ([Figure 1A][1], [Online Video 1][2]), a severe ostial lesion, and ecstatic

This image series shows how bypass grafts may tent the vessel to which they are anastomosed, potentially changing the expected course of the native coronary vessel. This fact must be taken into account during CTO-PCI, and this case emphasizes the importance of careful analysis of coronary anatomy with several angiographic projections.

A 73-year-old woman with a severely calcified critical stenosis in the midleft anterior descending coronary artery ([Figure 1A][1]) was referred for percutaneous coronary intervention. Pre-dilatation with a 2.5-mm noncompliant balloon at 20 atm pressure did not achieve adequate balloon expansion

Severe stenosis of the subclavian artery is a rare clinical finding, even more so for bilateral existence of the condition. Subclavian artery stenosis leads to erroneously normal or even low blood pressure values when measured at the brachial artery on the ipsilateral side. The poor control of blood pressure may cause cardiovascular complications such as heart failure and acute pulmonary edema without the patient having high blood pressure in the arms. Widespread clinical reliance on a sole brachial measurement of blood pressure, particularly in the emergency room setting, may result in inappropriate clinical management in patients with conditions that alter brachial blood pressure. We report a case of acute diastolic heart failure secondary to hypertensive emergency hidden due to bilateral stenosis of both subclavian arteries in a patient with severe atherosclerosis, cerebrovascular disease, and symptoms of subclavian steal syndrome.

A 53-year-old man underwent percutaneous coronary intervention of a chronic total occlusion of the circumflex artery. A mini-crush stent technique with two drug-eluting stents was performed. To the best of our knowledge, this is the first case of coronary artery aneurysm affecting a bifurcated chronic total occlusion treated with a two-stent technique.

We have carefully read the article by Jolly et al.1 We congratulate the authors for the effort of pooling individual data from the most important trials regarding thrombus aspiration (TA). It confirms that routine TA should not be performed in this context. However, we would like to make some considerations. We agree that after the TAPAS trial (Thrombus Aspiration During Primary Percutaneous Coronary Intervention),2 TA became part of routine practice, and was probably overused. However, results of the TASTE (Thrombus Aspiration During ST-Segment Elevation Myocardial Infarction)3 and TOTAL (Randomized Trial of Primary PCI With or Without Routine Manual Thrombectomy)4 trials, which drive the bulk of the overall effect …