Radial artery pseudoaneurysm (RAP) at the site of transradial access (TRA) for coronary angiography is rare. A clean puncture, secure bandage, and watchful follow‐up are must to prevent complete occlusion and aneurysm formation at the access site. This illustration describes surgical repair as one of the successful strategies to repair a postcatheterization RAP after TRA.

We report a rare case of inadvertent distal small diagonal branch perforation noted postleft anterior descending coronary artery revascularization, rescued by Gelfoam closure in a 43-year diabetic male presenting with acute anterior wall ST elevated myocardial infarction. Intermittent balloon inflation for 30 min was not able to seal off the perforation; because of impending late (3–6 h) cardiac tamponade, we closed the perforation with Gelfoam embolization through Caravel microcatheter. Although rarely practiced, this armamentarium should be there in the interventional cardiology laboratory to deal with small vessel perforation (<2 mm), for which traditionally covered stents are not available in size.

Background: Nail and hair changes occur in patients with uremia as well as in those undergoing dialysis. Early diagnosis and treatment is important to improve quality of life in CKD patients. Aim: To study nail and hair changes in chronic kidney disease patients. Material and Methods: A total of 100 patients with chronic kidney disease were studied for nail and hair changes. A thorough skin examination was done by dermatologist also and specific investigations such as skin biopsies, culture and sensitivity for bacterial infections, Gram's stain, potassium hydroxide mount, and fungal culture were performed wherever indicated. Results: Nail changes were found in 30 patients of CKD. The most common nail change being half and half nail (Lindsay nails) 12% patients. Hair changes were seen in 29 patients (29%), with the findings including sparse hair in 19 patients (19%). Nail and hair changes were predominantly found in stage 5D (18% and 11% respectively). Conclusion: The nail and hair changes were predominantly found in stage 5D. The most common nail change being half and half nail and most common hair change was sparse scalp hair. Recognizing and treating these manifestations can have multifactorial advantages in CKD patients.

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Spontaneous dissection of the coronary artery is a well-known entity in young females with myocardial infarction. We report a rare case of spontaneous spiral dissection of the left anterior descending coronary artery (LAD) in a 62-year-old male with history of smoking for 15 years and who has quit smoking 5 years back. Just like an old age saying "footprints are left behind," the deleterious conundrum of smoking continues even after years together resulting in a spontaneous dissection in the background of damaged arterial elastic media.