Entrapped Coronary Arteries in Constrictive Pericarditis.

Pericardial constriction can be present without pericardial calcium and often without pericardial thickening. This epicardial coronary artery motion abnormality due to entrapment in a thickened, fibrotic pericardium, is characteristic of constrictive pericarditis, and differentiates this entity from other close differential diagnoses, such as restrictive and dilated cardiomyopathy.

Adventitial Cystic Disease of the Popliteal Artery Contributing to Supera Stent Fracture.

A 60-year-old male presented with complaints of a non-healing wound on his right shin. Initial angiography showed a 100% occlusion of the right superficial femoral artery thought to be thrombotic in nature; he was treated with percutaneous transluminal angioplasty and stenting. Three weeks later, he presented with continuing symptoms of claudication. Angiography revealed stent fracture. Careful review of his prior angiogram was consistent with adventitial cystic disease of the popliteal artery as the cause of the popliteal artery occlusion. He was then referred for femoral-popliteal bypass.

Covered stents: A 25-year odyssey.

The concept of the PTFE-covered stent was introduced 25 years ago in the treatment of an aneurysmal vein graft. The study by Pavani et al. represents the largest cohort of patients treated with covered stents for Ellis type 3 perforations. Covered stents are effective in treating coronary perforations and remain an invaluable tool in the cardiac catheterization lab.

PCI on a tear: Not all perforations need coverage.

Coronary perforations are a potentially lethal complication of PCI requiring prompt treatment. The study by Rosseel et al demonstrates no difference in 5-year outcomes in patients with large coronary perforations treated with and without covered stents. Covered stents are effective in treating coronary perforations and are invaluable in the cardiac catheterization lab.