title: Pseudo dislodgement of a stent due to crumpling of a coronary artery: a hitherto unreported complication of the "accordion effect".
abstract: The "accordion effect" is a mechanical remodeling of the arterial wall produced by endoluminal introduction of stiff guidewires, leading to vessel wall shortening and development of multiple eccentric constrictions. This phenomenon is unresponsive to vasodilators and may lead to unnecessary stenting of the pseudo-lesions. It must be suspected with the development of multiple lesions and when a tortuous artery assumes a linear shape after advancing distally a stiff wire. In the situation of a complete occlusion of the artery the diagnosis may be challenging. Stenting in this scenario can be demanding because of the difficulty to appropriately size the length of the stent to the true lesion. We present a case of an unrecognized accordion phenomenon in an occluded coronary artery with a long dissection treated with two stents that after retrieving the wire were insufficient to cover the whole dissection.
authors.affiliation: Servicio de Hemodinamia y Cardioangiología Intervencionista, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: jorgeallin@hotmail.com.
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Allín
authors.affiliation: Servicio de Hemodinamia y Cardioangiología Intervencionista, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina; Servicio de Cardiología, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: José A
authors.initials: JA
authors.lastname: Álvarez
authors.affiliation: Servicio de Hemodinamia y Cardioangiología Intervencionista, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina; Servicio de Cardiología, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Leiva
authors.affiliation: Servicio de Hemodinamia y Cardioangiología Intervencionista, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina; Servicio de Cardiología, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Migliaro
authors.affiliation: Servicio de Cardiología, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Manuale
authors.affiliation: Servicio de Hemodinamia y Cardioangiología Intervencionista, Hospital Británico de Buenos Aires, Instituto del Corazón, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Pablo
authors.initials: P
authors.lastname: Baglioni
mesh_terms: D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology*; D011859:Radiography; D015607:Stents
keywords: Accordion effect; Angioplastia coronaria; Argentina; Coronary angioplasty; Crumpling; Efecto acordeón; Endoprótesis; Plegamiento; Pseudo dislodgement; Seudodesplazamiento; Stent