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Objectives: The aim of this study was to assess the clinical outcome of patients with diffuse coronary lesions treated with very long drug-eluting coronary stents (DES) (≥ 40 mm) over a period of one year. Methods: This single-center prospective study enrolled a total of 343 consecutive patients (376 long stents) who underwent percutaneous coronary stent implantation with very long DES. One year clinical outcomes were analyzed. A subgroup analysis of diabetic patients was also performed. Results: One year follow up data was available for 314 patients (91.5%). All-cause mortality was 5 (1.6%). Eleven (3.5%) patients had non-ST-elevation myocardial infarction. Definite / probable stent thrombosis was reported in 7 (2.2%) patients. Over one year, 3 (1%) patients underwent target lesion revascularization (TLR). The total number of target lesion failure was 9 (2.9%). The rate of target lesion failure at one year was 2.6% using one vessel per patient analysis. Two patients had ischemic stroke. Any major adverse cardiac event (MACE) was observed in 19 (6%) patients. The event rates between sirolimus and everolimus stent groups were compared - cardiac death (1.7% vs 1.5%; p = 0.911), stent thrombosis (2.5% vs 1.7%; p = 0.612), TLR (1% vs 0.8%; p = 0.878), any MACE (7% vs 4.1%; p = 0.284). Exertional dyspnea was reported by 47 (15%) patients at the end of one year. Dual antiplatelet adherence rate was 96% (n = 301 of 314). Conclusion: Use of very long stents (≥40 mm) for diffuse coronary lesions is safe and effective with acceptably low event rates. No significant differences in event rates were observed between the types of DES used in this study (Sirolimus Vs. everolimus). Keywords: Very long DES, Diffuse coronary lesion, PTCA, Long coronary lesion

We report a case of acute myocarditis in a middle aged woman in which the left ventricle morphologically mimics reverse takotsubo cardiomyopathy. The two conditions typically mimic acute coronary syndrome and have to be differentiated early. Our case emphasizes the importance of multimodal cardiac evaluation in suspected cases to achieve a correct diagnosis.

We report a case of successful performance of combined percutaneous intervention of complex coronary artery disease (CAD) and atrial septal defect (ASD) in a middle aged female. The case demonstrates the feasibility and safety of performing combined complex PTCA and ASD device closure in selected patients. Successful combined procedure obviates the need for major cardiac surgery and repeated hospitalizations. Such combined procedure can be an effective alternative for patients at high surgical risk.

We present a case of anomalous direct connection of the right superior caval vein to the left atrium. The diagnosis was made in a 2-year-old child with unexplained cyanosis and apparently normal heart. Corrective surgery was performed, and the child recovered completely.

We report a case of retrograde percutaneous transluminal angioplasty with stenting to chronically occluded upper limb vessels in a young female with Takayasu arteritis. A self-expanding stent (Supera peripheral stent system — Abbott Vascular, Santa Clara, CA, USA) was tracked retrogradely via ipsilateral radial access and the procedure was successful with good results. To our knowledge this is the first report of a Supera stent being tracked retrogradely through the radial artery. Learning objective: This case demonstrates the feasibility of tracking and successful deployment of Supera stent transradially.>