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Pseudo-lesions of a Tortuous Right Coronary Artery During Percutaneous Coronary Intervention: Accordion Phenomena

Cheikh Ahmed Abool Maaly1, Ihsan Rafie1, Fahad Alkindi1

  • 1Department of Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.

Heart Views : the Official Journal of the Gulf Heart Association
|July 15, 2017
PubMed

Insights

The accordion phenomenon, or guidewire-induced pseudo-lesions, can mimic serious coronary artery issues during procedures. Prompt recognition is key to avoid unnecessary interventions and manage potential complications.

Area of Science:

  • Interventional Cardiology
  • Vascular Imaging

Background:

  • Percutaneous coronary intervention (PCI) in tortuous coronary arteries presents unique challenges.
  • Guidewire manipulation can induce artifactual findings, complicating diagnosis.

Observation:

  • A case of multiple guidewire-induced pseudo-lesions (accordion phenomenon) in a tortuous right coronary artery during PCI is presented.
  • These pseudo-lesions were observed across several segments of the artery.

Findings:

  • The observed pseudo-lesions were refractory to standard treatment with intracoronary nitroglycerin.
  • Differential diagnoses considered included coronary dissection, thrombus, and spasm.

Implications:

  • Accurate identification of pseudo-lesions is crucial to prevent misdiagnosis and unnecessary interventions.
  • Understanding the accordion phenomenon aids interventionists in managing complex coronary anatomies safely.

Keywords:
Accordion phenomenaconcertina effectguidewire-induced coronary spasm

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