Introduction
Hepatic artery dissection is an uncommon clinical event with few reported cases in the literature. Although rare, most reported dissections have occurred in the setting of intra-arterial hepatic artery chemotherapy or as a complication of liver transplant.^1–3 Treatment strategies have included surgery and, more recently, percutaneous balloon angioplasty (PTA) with adjunctive bare-metal stents.^1,2,4,5 Improved endovascular technology has led the way to greater success in treating complex arterial disease. Drug-eluting stents (DES), specifically, have

Ever since Dr. Gruentzig performed the first coronary balloon angioplasty in 1977, we have, as interventional specialists, begun to see our own types of complications. First, the phenomenon of intimal hyperplasia with restenosis was born after the introduction of balloon angioplasty. When Parodi first described a technique to less invasively exclude abdominal aortic aneurysms, we also developed our own unique type of endovascular complications. Potential endoluminal graft complications include dissection or perforation, device malfunction or failure, a thromboembolic event, prosthetic occlusio

Emergency Stent-graft Repair for Thoracic Aortic Injury by Castelli et al. is an important paper that lends further credence to the notion that endovascular repair is rapidly becoming the new standard of care in the treatment of traumatic transection of the thoracic aorta. The results herein reported, like many others, are exciting and very promising. They seem to ‘overshadow’ anything and everything that standard surgical repair has accomplished over the past several decades as serious operative morbidity and mortality rates have remained high.

Thoracic stent-graft technologies

Percutaneous coronary intervention (PCI) with stenting has been shown to enhance platelet aggregation.¹ Accordingly, optimization of antiplatelet therapy has a crucial role in patients undergoing percutaneous revascularization and even more “aggressive” antiplatelet therapies have been employed to prevent postprocedural thrombotic complications.^2,3

Dual oral antiplatelet pretreatment with aspirin plus ticlopidine has dramatically reduced the occurrence of subacute thrombosis and early adverse events after coronary stenting.⁴ Clopidogrel is an antiplate

Vascular injury leads to platelet activation and aggregation, and subsequent fibrin deposition and thrombosis. Antithrombin therapy alone without optimal platelet inhibition leads to an inferior outcome during percutaneous coronary intervention (PCI).

Early experience with PCI was performed with unfractionated heparin (UFH) in patients pretreated with aspirin. Aspirin is only partially effective as an antiplatelet drug by inhibiting the cyclooxygenase enzyme and therefore partially blocking thromboxane A2 and collagen-mediated platelet activation and aggregation. However, there are several