13-04-2011 | Imaging in Cardiology
Concertina
Gepubliceerd in: Netherlands Heart Journal
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A 75-year old lady with previous stenting of the mid-portion of the right coronary artery (RCA) and left anterior descendens (LAD) had recurrence of typical exertional angina despite optimal medical treatment and was scheduled for coronary angiography. This showed a moderate to severe in-stent restenosis (Fig. 1a, arrow) in a tortuous RCA and a prominent curve between mid-and distal RCA (Fig. 1a, arrowhead). After pre-dilatation and stenting using a drug-eluting stent, the angiogram with angioplasty guidewire in situ showed a good result at the stented section, but a new ‘stenosis’ at the border between mid- and distal RCA (Fig. 1b, arrow). As the curve between mid- and distal RCA had disappeared, we suspected a ‘concertina’-phenomenon which was confirmed upon partial withdrawal of the guide-wire: the curve re-appeared (Fig. 1c, arrowhead) and the ‘stenosis’ disappeared. Final angiogram after complete withdrawal of guidewire (Fig. 1d) revealed a satisfactory end-result.×
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