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Rescue of iatrogenic spiral dissections using an intravascular ultrasound-guided parallel wire technique

Sharma, Harish
Khan, Arif
Wrigley, Benjamin
Khan, Sohail Q
Abstract
Percutaneous coronary intervention carries a risk of iatrogenic catheter dissection. A spiral aorto-ostial dissection can completely occlude the vessel and cause ischemia with significant hemodynamic compromise. The mortality from such dissections is approximately 6.5%. The situation can be rescued percutaneously by stenting the true lumen open, but this relies on having a wire within the true lumen. Large dissections often have a small true lumen that is hard to wire and a large false lumen that wires easily. There is a paucity of literature outlining the necessary steps to achieve procedural success. This case series includes 2 spiral dissections and demonstrates a step-by-step approach to manage this situation successfully.
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Date
2025-02-05
Type
Article
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Citation
Sharma H, Khan A, Wrigley B, Khan SQ. Rescue of Iatrogenic Spiral Dissections Using an Intravascular Ultrasound-Guided Parallel Wire Technique. JACC Case Rep. 2025 Feb 5;30(3):103121. doi: 10.1016/j.jaccas.2024.103121.
Journal / Source Title
JACC. Case Reports
DOI
10.1016/j.jaccas.2024.103121
PMID
39963218
Publisher
Elsevier
Publisher’s URL
https://www.sciencedirect.com/journal/jacc-case-reports
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Note / Copyright