ArticleEuropean heart journal. Case reports2023
Intravascular ultrasound-guided dissection recanalization in a patient with ST-segment elevation myocardial infarction: a case report.
Article in European heart journal. Case reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 4 citations in OpenAlex.
- Angiography- and IVUS-tip-detection-guided 3D wiring for CTO and non-CTO percutaneous coronary interventions.Cardiovascular intervention and therapeutics · 2026Review
- Intravascular ultrasound-guided tip detection-antegrade dissection re-entry as a bailout technique for coronary artery dissection: a case report.European heart journal. Case reports · 2026Article
- Side branch preservation using tip detection-antegrade dissection re-entry after failed subintimal tracking and re-entry in chronic total occlusion: a case report.European heart journal. Case reports · 2024Article
- Tip detection-antegrade dissection and re-entry (TD-ADR) with integrated fluoroscopic and intravascular ultrasound images in chronic total occlusion: first case report of integrated TD-ADR technique.European heart journal. Case reports · 2024Article
- First successful implementation of subintimal transcatheter withdrawal technique in intravascular ultrasound-guided tip detection antegrade dissection and reentry: a case report.European heart journal. Case reports · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In primary percutaneous coronary intervention (PCI) for acute myocardial infarction, we occasionally experience challenging cases where conventional guidewires cannot pass through the lesion. In such cases, if the use of a tapered guidewire or polymer jacket guidewire is also unsuccessful, coronary artery bypass surgery becomes inevitable. Therefore, other methods to enable revascularization in a reliable and timely manner are desirable. Case summary: We present the first case of intravenous ultrasound (IVUS)-guided tip detection (TD)-antegrade dissection re-entry (ADR) in a 73-year-old man who suffered ST-segment elevation myocardial infarction (STEMI). The patient had a total thrombotic occlusion of the right coronary artery and stenotic lesion of the left anterior descending artery. Primary PCI was unsuccessful and IVUS-guided rewiring using a chronic total occlusion (CTO) wire failed due to thrombus attenuation. However, IVUS imaging revealed the presence of intimal and subintimal space, which led us to perform IVUS-guided TD-ADR using Conquest Pro 12 ST (Asahi Intecc). Using the TD method, we were successful in swiftly puncturing the true lumen wall, and a stent was implanted following successful re-entry. Final angiography showed the establishment of Thrombolysis in Myocardial Infraction-3 flow and resolution of ST-segment elevation. Discussion: IVUS-guided TD enables accurate puncture in an ADR procedure, enabling successful recanalization in a relatively short time. Thus, IVUS-guided TD-ADR is a reliable option for revascularization in STEMI cases wherein the guidewire fails to pass the occlusion using conventional techniques.
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