title: Iatrogenic coronary dissection causing flush side branch occlusion: use of intravascular ultrasound to reopen vessel.
abstract: Iatrogenic complications present a major challenge to the interventional cardiologist. We describe a case of extensive right coronary artery dissection caused by engagement of a 0.035" guidewire. Attempts to reopen the flush-occluded posterior descending artery using conventional methods were unsuccessful. However, the vessel was successfully restored with the use of intravascular ultrasound guidance and we describe the steps involved in this technique.
authors.affiliation: Cardiology Registrar, Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK. dr.pdwilliams@gmail.com
authors.forename: Paul D
authors.initials: PD
authors.lastname: Williams
authors.forename: Haidar
authors.initials: H
authors.lastname: Hadi
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Fraser
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003331:Coronary Vessels / Q000293:injuries*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D015607:Stents; D018084:Ultrasonography, Interventional