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Accordion effect in tortuous right coronary arteries during percutaneous transluminal coronary angioplasty
R A Rauh1, R W Ninneman, D Joseph
1Department of Medicine, University of Wisconsin, Madison.
Insights
Coronary angioplasty can cause complications like spasm or dissection. This report details cases where mechanical deformation mimicked these issues in tortuous arteries, highlighting a crucial diagnostic challenge.
Area of Science:
- Interventional Cardiology
- Cardiovascular Imaging
Background:
- Coronary angioplasty is a common procedure for treating coronary artery disease.
- Coronary spasm and intimal dissection are recognized complications that require prompt intervention to prevent vessel occlusion.
Observation:
- Two cases are presented involving mechanical deformation of the coronary artery.
- This deformation was caused by angioplasty hardware during procedures on tortuous native right coronary arteries.
Findings:
- The mechanical deformation mimicked the appearance of intimal dissection or coronary spasm.
- This presentation posed a diagnostic challenge, potentially leading to incorrect treatment decisions.
Implications:
- Accurate differentiation between mechanical deformation and true dissection/spasm is critical for appropriate patient management.
- Awareness of this phenomenon is important for interventional cardiologists performing angioplasty in complex anatomies.
- This highlights the need for careful assessment of angioplasty hardware interactions in tortuous vessels.
Abstract:
Coronary spasm and intimal dissection are well-known complications of coronary angioplasty with potentially serious consequences. Their treatments are different and need to be instituted quickly to prevent vessel closure. We report two cases of mechanical deformation caused by the angioplasty hardware masquerading as dissection or spasm during coronary angioplasty of tortuous native right coronary arteries.