Use of Extra Deep Guide-Catheter Intubation for Rotablation-Facilitated Percutaneous Coronary Intervention of the Right Coronary Artery

We describe a case of an 84-year old gentleman undergoing PCI of a heavily calcified and stenotic right coronary artery. Rotational atherectomywas employed, but due to difficulties inwiring and burr advancement, extra deep guide-catheter intubation was used to provide support and facilitate advancement of the burr and subsequent stent deployment. An approach with careful extra deep guide-catheter intubation in rotablation is an option that might be considered for selected cases with severely stenotic, calcified, angulated lesions. (C) 2019 Elsevier Inc. All rights reserved

Pseudo-aneurysm in ascending aorta detected 15 years after aortic valve replacement

We describe the case of a woman which was found incidentally on catheterization to have a pseudo-aneurysm of the ascending aorta at the site of a previously (15 years ago) implanted metallic prosthetic aortic valve. Angiographic and computed tomography images are provided, which demonstrate the pseudo-aneurysm. (C) 2008 Elsevier Ireland Ltd. All rights reserved

The Role of Matrix Metalloproteinases in Essential Hypertension

The matrix metalloproteinases/tissue inhibitors of metalloproteinases system is involved in the regulation of extracellular matrix metabolism, which plays a crucial role with regards to maintenance of tissue integrity. During the occurrence of vascular pathologies including hypertension, the balance between proteases and their inhibitors is temporally destroyed. Even though there are conflicting data in the literature regarding the expression pattern of the vascular matrix metalloproteinase system, the occurring extracellular matrix turnover leads to the change of arterial mechanical properties. For example, hypertension plays crucial role in the formation of cardiovascular remodeling which seems to be characterized by an increase in extracellular matrix. Changes in arterial stiffness, a predictor for cardiovascular morbidity and mortality, are determined by alterations in vascular extracellular matrix due to hemodynamic, genetic, or other factors. It has become increasingly evident that blockade of the renin-angiotensin-aldosterone system and other pharmacological strategies, seem to be particularly effective in reducing vascular stiffness and collagen content in human and animal models. However, the relationship between extracellular matrix metabolism and the effects of therapy in hypertensive patients needs to be further explored in larger trials over a longer period of time