The double helix angiography of right coronary arteries: false lumen stenting of a type F right coronary artery spiral dissection with late recanalization of the true lumen and occlusion of the stented false lumen
Guide catheter induced dissection of coronary arteries is an uncommon, but serious complication of coronary angioplasty. Treatment can include emergent coronary artery bypass grafting to the affected vessel or percutaneous intervention including wiring the true lumen and exclusion stenting of the dissection flap to prevent further propagation. Detailed descriptions have been published of techniques of intentional passage of guide wires into the false lumen and reentry into the true lumen with chronic total occlusions. We present an unusual case of what appeared to be successful intentional false lumen stenting with reentry into the true lumen of an iatrogenic dissection of the right coronary artery with restoration of TIMI III coronary flow which, one year later, was complicated by recanalization of the true lumen and occlusion of the stented false lumen causing symptomatic angina.
Coronary dissection, Percutaneous coronary intervention, Complication, Cardiac CT
Financial support: None.
Farrukh Hussain Section of Cardiology Department of Internal Medicine Faculty of Medicine University of Manitoba St. Boniface General Hospital 409 Taché Avenue, Winnipeg Manitoba, R2H 2A6, Canada email@example.com
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