Pseudo-lesions of a tortuous right coronary artery during percutaneous coronary intervention: Accordion phenomena

• Main Authors: Cheikh Ahmed Abool Maaly, Ihsan Rafie, Fahad Alkindi
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Heart Views
• Subjects: Accordion phenomena; concertina effect; guidewire-induced coronary spasm
• Online Access: http://www.heartviews.org/article.asp?issn=1995-705X;year=2017;volume=18;issue=2;spage=47;epage=49;aulast=Maaly

Guidewire-induced pseudo-lesions are referred to accordion phenomenon and are infrequent occurrences during percutaneous coronary intervention of tortuous coronary arteries. Their occurrence can be a diagnostic challenge to the interventionist and might lead to unnecessary intervention. Ischemia and hemodynamic compromise are possible complications, if not managed promptly. The differential diagnosis includes coronary dissection, thrombus, and spasm. We describe a patient who developed pseudo-lesions of the tortuous right coronary artery in multiple segments during PCI. The pseudo-lesions were refractory to intracoronary nitrogycerin.