Rescue of iatrogenic spiral dissections using an intravascular ultrasound-guided parallel wire technique
Sharma, Harish Khan, Arif Wrigley, Benjamin Khan, Sohail Q
Sharma, Harish
Khan, Arif
Wrigley, Benjamin
Khan, Sohail Q
Affiliation
University of Birmingham; University Hospitals Birmingham NHS Foundation Trust; Royal Wolverhampton NHS Trust
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Publication date
2025-02-05
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Abstract
Percutaneous coronary intervention carries a risk of iatrogenic catheter dissection. A spiral aorto-ostial dissection can completely occlude the vessel and cause ischemia with significant hemodynamic compromise. The mortality from such dissections is approximately 6.5%. The situation can be rescued percutaneously by stenting the true lumen open, but this relies on having a wire within the true lumen. Large dissections often have a small true lumen that is hard to wire and a large false lumen that wires easily. There is a paucity of literature outlining the necessary steps to achieve procedural success. This case series includes 2 spiral dissections and demonstrates a step-by-step approach to manage this situation successfully.
Citation
Sharma H, Khan A, Wrigley B, Khan SQ. Rescue of Iatrogenic Spiral Dissections Using an Intravascular Ultrasound-Guided Parallel Wire Technique. JACC Case Rep. 2025 Feb 5;30(3):103121. doi: 10.1016/j.jaccas.2024.103121.
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Article