Welcome to our annual issue focused on procedural techniques in which we enlist expert operators to provide their tips and tricks to help you advance your practice. Our series of technique features begins with Moemen Eltelbany, MD; Lindsey Cilia, MD; and Alexander Truesdell, MD, delivering a how-to guide for using intravascular imaging modalities to aid in the treatment of coronary artery calcification.

Next, Rhian E. Davies, DO, and Jeremy D. Rier, DO, provide an assessment of the subintimal tracking and reentry method in practice and explain when and how to do it and how to troubleshoot cases.

Jasleen Tiwana, MD; Jesse A. Kane, MD; and Lorenzo Azzalini, MD, dive into the process of device-based antegrade dissection and reentry, offering a stepwise guide for various devices. Then, Dr. Kane, Dr. Tiwana, and Kathleen Kearney, MD, illustrate how to use echocardiography with ultrasound enhancing agents to aid in the management of coronary artery perforations.

Pier Pasquale Leone, MD, and Dr. Latib show how ultrasound-guided deployment of suture-based vascular closure devices can result in better outcomes and less complications. Michael Ragosta, MD, walks us through using alcohol septal ablation in hypertrophic cardiomyopathy patients with left ventricular outflow tract obstruction, highlighting patient criteria, pre- and postprocedure considerations, and a description of the technique.

Guillaume Bonnet, MD; Lionel Leroux, MD; Julien Peltan, MD; Louis Labrousse, MD; Julien Ternacle, MD; Stéphane Lafitte, MD; and Thomas Modine, MD, describe the why and how for transcarotid access in transcatheter aortic valve replacement, discussing feasibility and clinical studies and procedural tips and tricks.

Sareena George, MD; Ari J. Mintz, DO; Sanjum Sethi, MD; and Sahil A. Parikh, MD, examine existing options for treating femoral pseudoaneurysms, including ultrasound-guided compression or thrombin injection, surgical repair, and endovascular repair.

We end our cover focus with technical tips for inserting the Impella device (Abiomed). Luca Baldetti, MD; Alessandro Beneduce, MD; Alaide Chieffo, MD; and Anna Mara Scandroglio, MD, provide a practical guide to insertion, repositioning, and managing related complications.

In our Today’s Practice column, Denise Busman, MSN, RN, evaluates whether it is time for same-day discharge to become the default strategy for left atrial appendage occlusion procedures.

We close this issue by interviewing Joost Daemen, MD, who discusses how to incorporate image-based physiology into practice for percutaneous coronary intervention, predictions for the future of renal denervation, and his experience leading the FAST STEMI II trial.

We hope that you find this issue to be of interest and use in your practice.

Kathryn Dawson, MD
Guest Chief Medical Editor
Azeem Latib, MD
Chief Medical Editor