Related Experiment Videos
A case of accordion phenomenon accompanied by severe transmural myocardial ischemia
Naotsugu Oyama1, Kazushi Urasawa, Hidetsugu Sakai
1Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Insights
A rare case of severe myocardial ischemia occurred after percutaneous coronary intervention in a tortuous right coronary artery. Straightening the artery caused the accordion phenomenon, leading to slow blood flow and chest pain.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Biology
Background:
- Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
- Severely tortuous coronary arteries present unique challenges during PCI.
- The accordion phenomenon is a rare complication that can occur during vascular interventions.
Observation:
- A patient with a severely tortuous right coronary artery (RCA) underwent PCI.
- Two guidewires were used to straighten the tortuous RCA during the procedure.
- Immediately after straightening, the patient developed angiographic slow flow, electrocardiographic changes, and anginal pain.
Findings:
- The patient experienced severe myocardial ischemia.
- The ischemia was directly attributed to the accordion phenomenon, a consequence of straightening the tortuous RCA.
- This case highlights a rare but significant complication of PCI in tortuous vessels.
Implications:
- Awareness of the accordion phenomenon is crucial for interventional cardiologists performing PCI in tortuous coronary arteries.
- Careful technique and consideration of potential complications are necessary to optimize patient outcomes.
- Further research may explore preventative strategies or modified approaches for PCI in highly tortuous vessels.
Abstract:
Percutaneous coronary intervention was performed in a severely tortuous right coronary artery (RCA). Immediately after straightening its tortuousity by using two guidewires, angiographic slow flow, ischemic electrocardiographic changes, and anginal pain developed. This is a rare case who had severe myocardial ischemia caused by the accordion phenomenon.