Coronary accordion effect mimicking coronary dissection

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• The coronary accordion effect is a rare pseudo-complication during percutaneous coronary intervention (PCI).
• It typically results from the straightening and shortening of tortuous coronary arteries when using stiff guidewires.
• Understanding this phenomenon is crucial for accurate interpretation of coronary angiography post-PCI.

Purpose of the Study:

• To report a case of the coronary accordion effect observed during PCI.
• To highlight the characteristic angiographic appearance and potential causes.
• To contribute to the literature on rare PCI complications.

Main Methods:

• Case report of a 52-year-old woman undergoing PCI.
• Review of angiographic findings during and after the procedure.
• Correlation of the observed effect with guidewire manipulation and vessel characteristics.

Main Results:

• The coronary accordion effect was observed in the patient during PCI.
• The effect was characterized by apparent shortening and "bunching" of the coronary artery segment.
• The pseudo-complication resolved after guidewire removal.

Conclusions:

• The coronary accordion effect is a benign, transient phenomenon.
• It should not be mistaken for actual coronary artery dissection or other serious complications.
• Awareness of this effect aids interventional cardiologists in avoiding misdiagnosis during PCI.