UNASSIGNED: Thromboembolic events with the use of immune checkpoint inhibitors (ICIs) in patients with cancer have been reported in few studies. However, the detailed profile of these cases remains mostly uncertain.
UNASSIGNED: A descriptive analysis of Thromboembolic events associated with ICIs retrieved from the VigiBase, between 1967 to November 2020. We extracted the data using the terms of \'pulmonary embolism\' OR \'deep vein thrombosis\' OR \'acute coronary syndrome\' OR \'myocardial infarction\' OR \'ischemic stroke\' (preferred term (PT) (MedDRA).
UNASSIGNED: We included 161 cases from 26 countries in our descriptive analysis. Patients\' ages were reported in 141 (87.6%) cases, with a median of 68 years (interquartile range 61-74), and 63.4% of the patients were male. Indications for ICIs were reported in 151 (93.8%) cases, as follows: lung cancer (n = 85, 52.8%), renal cell carcinoma (n = 24, 14.9%), melanoma (n = 20, 12.4%), urethral carcinoma (n = 12, 7.45%), breast cancer (n = 4, 2.48%), adenocarcinoma of the gastroesophageal junction (n = 3, 1.9%), gastric cancer (n = 2, 1.24%), and skin cancer (n = 1, 0.62%). Nivolumab was reported as a suspected drug in 76 cases (47%), pembrolizumab in 46 cases (28.5%), atezolizumab in 21 cases (13%), durvalumab in 14 cases (8.6%), and avelumab in four cases (2.4%).The time to onset of thromboembolic events was reported in 127 (78.8%) cases. Most of these patients (n = 109, 85.8%) reported thromboembolic events within the first six months. The causality assessment of included cases showed that 50.3% of reported thromboembolic events were possibly related to the suspected reported medication, 13.7% were probably related, 13% were unlikely to be related, and 23% were not assessable due to insufficient information.
UNASSIGNED: This study demonstrates a possible association between the use of ICIs and thromboembolic events. Further epidemiological studies are needed to assess this association and to elucidate the underlying mechanism.

Double right coronary artery (RCA) is an extremely uncommon anomaly that is mostly detected incidentally in patients undergoing coronary angiography. It can be a benign and isolated anomaly or associated with other congenital abnormalities, mostly other coronary anomalies. Although atherosclerosis and myocardial ischemia have been frequently reported in patients with double RCA, this likely reflects that the patients were evaluated for chest pain rather than the predisposition to atherosclerosis in double RCA. Paralleling the increased awareness of this entity and the availability of non-invasive and cost-effective imaging of the coronary arteries, the diagnosis of double RCA has increased recently. Here, we present a case of double RCA diagnosed by coronary computed tomographic angiography, and provide a mini-review on the demography, anatomic variants, and clinical significance of double RCA.

A 68-year-old man presented following a cardiac arrest. Cardiopulmonary resuscitation was performed by the Lund University Cardiopulmonary Assist System (LUCAS), a mechanical chest compression device. Investigations revealed an aortic dissection, which was likely an iatrogenic injury from mechanical cardiopulmonary resuscitation by LUCAS. This case highlights this potential complication. (Level of Difficulty: Beginner.).

The detection of spontaneous coronary artery dissection (SCAD) causing myocardial infarction is integral in pursuing the appropriate management. Our case posed a diagnostic challenge, with Takotsubo cardiomyopathy and coronary embolism among the potential differential diagnoses upon the initial presentation. Extensive propagation of spontaneous coronary artery dissection subsequently resulted in a significant challenge to management requiring surgical revascularization. (Level of Difficulty: Intermediate.).

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