ArticleCase reports in cardiology2024
Successful Bailout of Catheter-Induced Dissection in Acute Myocardial Infarction Resulting From a Nondominant Right Coronary Artery Occlusion.
Article in Case reports in cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- 'Balloon screen' technique: a case report of a novel bailout strategy for accurate stent deployment in severely calcified coronary lesions complicated by dissection.European heart journal. Case reports · 2026Article
- Comparison of prognosis between intravascular ultrasound-guided and angiography-guided percutaneous coronary intervention in patients with acute coronary syndrome.American journal of translational research · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A 48-year-old male with a history of hyperlipidemia presented to the emergency department with chest pain. Electrocardiographic abnormalities indicated an acute coronary syndrome. Urgent coronary angiography revealed nondominant right coronary artery (RCA) occlusion. During primary percutaneous coronary intervention (PCI), a 0.014-inch floppy guidewire could not be easily advanced into the middle RCA due to poor backup support from the guiding catheter and the patient's breathing. The pressure was monitored several times after reinserting the guiding catheter. Nevertheless, the guidewire was inadvertently inserted into the false lumen from the ostium, leading to subsequent dissection during contrast injection. Intravascular ultrasound (IVUS) imaging confirmed dissection from the ostium to the middle RCA and passage of the guidewire into the false lumen. An additional guidewire was successfully inserted into the true lumen of the RCA using real-time IVUS-guided wiring. We demonstrated successful bailout stenting for catheter-induced dissection of the nondominant small RCA. Our case highlights the risk of coronary artery dissection associated with guiding catheter use, especially in a nondominant small RCA, and the importance of optimal guiding catheter selection for primary PCI. The real-time IVUS-guided wiring technique can be applied to a single 6-Fr guiding catheter and is useful for quickly inserting a guidewire into the true lumen.
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