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Novel Use of Dual-Lumen Microcatheter for False Lumen Hematoma Decompression: Tools for Consideration
Elizabeth D A Chan1, Zeeshan Ahmed1, Aun Yeong Chong1
1University of Ottawa Heart Institute, University of Ottawa, Ottawa, Canada.
Insights
This study presents a novel technique for managing iatrogenic coronary artery dissection, a dangerous complication during cardiac catheterization. Repurposing a dual-lumen microcatheter successfully treated a case, offering a new tool for interventional cardiologists.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Device Innovation
Background:
- Iatrogenic coronary artery dissection is a serious complication of cardiac catheterization.
- Prompt management is crucial due to high associated mortality rates.
Background:
Management of iatrogenic coronary dissection is essential for all interventional cardiologists considering its incidence and high associated mortality.
Case Summary:
A 66-year-old woman undergoing elective left and right heart catheterization for investigation of shortness of breath experienced iatrogenic catheter-induced ostial right coronary artery dissection. Use of intravascular ultrasound and repurposing a dual-lumen microcatheter enabled successful wiring of true lumen and percutaneous management.
Discussion:
Novel use and repurposing of available coronary equipment in the form of a dual-lumen microcatheter provided additional tools for management of this dangerous complication.
Take-Home Messages:
Coronary dissection regardless of mechanism can be fatal and difficult to manage given size differences of the true and false lumen. Use of a dual-lumen microcatheter placed into the false dissection lumen with negative pressure applied can decompress the hematoma and enable wiring of the true lumen for percutaneous management.
