We report a patient with ischemic cardiomyopathy status post implantable cardioverter-defibrillator (ICD) implantation in June 2009. Outer insulation failure of her Riata ST ventricular ICD lead goes undetected by routine interrogation and provocative tests as recommended from its manufacturer.(1) Another domain of assessment, fluoroscopy, to facilitate early detection of structural abnormality in this family of ICD lead is discussed.

We report a successful carotid angioplasty in a patient with symptomatic and critical aortic stenosis. The safety and feasibility of this technique in this scenario have not been well established and reported. With careful planning and technique, we believe the procedure should be safe and feasible.

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