The use of multiple coronary guidewires to occupy secondary branch vessels and facilitate PCI of a complex aneurysmal stenosis.
Percutaneous revascularization of complex coronary stenosis is dependent on establishing suitable guidewire position in the vascular bed distal to the lesion. We report the use of multiple 0.0014'' coronary guidewires to occupy unintended branch vessels and to facilitate PCI of a high-grade left circumflex obtuse marginal branch lesion with post-stenotic aneurysmal dilation of the vessel and multiple branch vessels. This technique enabled successful placement of a nitinol hydrophilic-coated wire into the distal vascular bed beyond the region of obstruction followed by placement of a drug-eluting stent with restoration of luminal dimensions and TIMI-3 angiographic flow.
Pulukurthy
Satyauardhan
S
Medical Device Research Laboratory, Borgess Medical Center, Michigan State University School of Medicine, Kalamazoo, Michigan 49048, USA.
Carter
Andrew J
AJ
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006322:Heart Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans