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Published on: September 5, 2011
The parallel wire technique to deal with wire-induced dissection of a complex calcified lesion
1Department of Cardiology, St. Boniface General Hospital, 409 Tache Avenue, Winnipeg, MB, Canada. fhussain@sbgh.mb.ca
Insights
Coronary dissection during angioplasty can be challenging. A novel case successfully used the parallel wire technique to recanalize a complex wire-induced dissection in the right coronary artery.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary dissection is a known complication of percutaneous coronary interventions.
- Identifying the true lumen after severe dissection can be technically demanding.
Observation:
- A case of extensive wire-induced dissection occurred in a calcific and tortuous right coronary artery.
- The dissection complicated a standard coronary angioplasty procedure.
Findings:
- The parallel wire technique, previously used for chronic total occlusions, was employed.
- This technique successfully recanalized the complex dissection, allowing for restoration of coronary blood flow.
Implications:
- The parallel wire technique offers a viable strategy for managing complex dissections.
- This approach may improve outcomes in challenging coronary angioplasty cases involving dissections.
Abstract:
Coronary dissection is not an uncommon phenomenon during coronary angioplasty. Coronary dissection can occur due to a variety of interventions, including balloon inflation, atherectomy, stent edge dissections, guide catheter trauma and wire-induced dissections, to name a few. Once a severe dissection has occurred, it is often challenging to find the true lumen. The parallel wire technique has been described in the literature for the recanalization of chronic total occlusions and also to recanalize guide catheter-induced spiral dissections of the right coronary artery. We report a novel case of an extensive wire-induced dissection of a calcific and tortuous right coronary artery, which was recanalized using the parallel wire technique.