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Coronary stenting has begun to play an increasingly important role in the management of coronary artery aneurysms. A case of successful and complete sealing of a coronary aneurysm by using a new stent graft is described. Further studies in a large patient population are required to confirm the safety and efficacy of this method. Cathet. Cardiovasc. Intervent. 48:96-99, 1999., (Copyright 1999 Wiley-Liss, Inc.)

The intracoronary stent placement in a lesion proximal to a myocardial bridge is of special importance and is considered to be a challenge for the interventional cardiologist. In this study 4 cases of stent implantation proximal to a coronary bridged segment are described. In all cases complications were observed after the procedure. The patients remained free of symptoms and the exercise TI201 test was negative for ischemia 8.5+/-2.6 months later. Although there is skepticism because of the abnormal coronary flow pattern, the endothelial dysfunction and the subsequent thrombogenicity, the stent placement proximal to a myocardial bridge was safe and with favorable long term results in all 4 cases. However, further studies in large populations are necessary.

Stent dislodgment from the delivery catheter is a well-known complication of angioplasty with stent implantation. The aim of our study was to investigate the feasibility, effectiveness, and safety of a new technique of intracoronary stent implantation in order to avoid stent loss in the intravascular space. Fifty consecutive patients were candidates for angioplasty and stent placement. During angioplasty, a technique was followed according to which the guide wire "hindered" the dislodgment of the stent from the balloon catheter. Successful angioplasty and stent placement were performed in 46 out of 50 patients (92% success rate). In three cases of failure of stent implantation, the stent moved onto the balloon catheter; however, this was impeded by the guide wire. One non-Q-wave myocardial infarction occurred. No major complications (Q-wave myocardial infarction, CABG, or death) were observed. In conclusion, the technique applied was feasible enough, safe, and effective. However, the appropriate modification of its "hardware" will render it even more feasible and user-friendly.

A case of angiographic catheter entrapment in the right coronary artery during coronary angiography in a patient with excessive tortuosity of the right iliac artery is described. Alternative manipulations in order to avoid this problem are presented.

Aneurysms of the mitral-aortic interventricular fibrosa (MAIF) are exceptionally rare complications, commonly following aortic valve endocarditis. This report describes the angiographic findings of such an aneurysm, in a patient who developed an uncommon symptomatology of unstable angina pectoris, caused by the aneurysm's expansion against the coronary arteries. Surgical treatment is also discussed.

In this report we describe a case in which a saphenous vein graft stenosis at the site of anastomosis with the left anterior descending artery (LAD) was dilated with a special Controlled Angioplasty Technology (CAT) balloon, and then stented. Balloon angioplasty and stenting at the site of anastomosis represents a technical problem because of diameter discrepancy and needs special attention in order to avoid minor or major complications.

The "Y connector" that is used in angioplasty has the following disadvantages: 1) it is not blood-tight; 2) we need to "screw and unscrew" every time we want to inject contrast material or measure the pressure; and 3) it does not allow the advancement of the guidewire or the balloon catheter during the injection of contrast material. We created a new type of connection composed of a cut sheath for the femoral artery, connected with a cut (at the "hub") guiding catheter. The aim of this study was to examine the feasibility, efficacy, and safety of the new method. Using the new technique we performed plain-balloon angioplasty, implantation of stent, and atherectomy in 350 patients. The technical success of the method was 100%, and no complications related to the method were seen. In conclusion, the novel connection that we created eliminated all the disadvantages of the "Y connector" and was found to have 100% technical success and safety.