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Rescue of Iatrogenic Spiral Dissections Using an Intravascular Ultrasound-Guided Parallel Wire Technique

Year: 2025

Type: article

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.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2024.103121

Authors: Harish Sharma, Arif Khan, Benjamin Wrigley, Sohail Q. Khan

Institutions: University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, The Royal Wolverhampton NHS Trust

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850