The crumpled coronary: an enigma of arteriographic pseudopathology and its potential for misinterpretation.
A series of angioplasty cases is presented in which dynamic alterations in coronary artery configuration developed. These changes were suggestive of extensive, complex dissections. Several common features emerged in these cases of which interventional cardiologists should be aware. These features included complex vessel morphology (tortuous segments, anomalous takeoffs, and complex stenoses) and the use of certain types of PTCA hardware (Amplatz guiding catheters and 0.018-inch wires). This phenomenon, termed pseudo narrowing, remains largely unrecognized. Identification of these characteristics and employment of proper management strategies will ensure a good outcome in these situations when they arise.
Hays
J T
JT
Department of Medicine, Methodist Hospital, Houston, Texas 77030.
Stein
B
B
Raizner
A E
AE
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017222:Angioplasty, Balloon, Laser-Assisted / Q000295:instrumentation*; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D004868:Equipment Failure; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012086:Reoperation