Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique”
We present a rare case of revascularization of right coronary artery long flap dissection with novel prolapsing knuckle wire technique as the wire was repeatedly entering into the large medial dissection flap rendering the forward advancement of the wire impossible to cross the lesion. We negotiated...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-12-01
|
| Series: | Heart India |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/heartindia.heartindia_19_24 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841554642182340608 |
|---|---|
| author | Debasish Das Satyapriya Mohanty Abhinav Kumar Anindya Banerjee Pranjit Deb Subash Pramanik |
| author_facet | Debasish Das Satyapriya Mohanty Abhinav Kumar Anindya Banerjee Pranjit Deb Subash Pramanik |
| author_sort | Debasish Das |
| collection | DOAJ |
| description | We present a rare case of revascularization of right coronary artery long flap dissection with novel prolapsing knuckle wire technique as the wire was repeatedly entering into the large medial dissection flap rendering the forward advancement of the wire impossible to cross the lesion. We negotiated the wire gently into the bottom of the dissection flap and pushed the wire gently so that the wire will ascend up and form a U loop inside the dissection flap. Further gentle advancement of the wire prolapsed the wire tip into the main lumen mimicking the fact that the dissection flap vomited out the wire into the main lumen. Keeping the tip of the wire in the main lumen, gentle pulling of the wire straightened the U loop, wire came out of the false lumen and gentle forward push with torque keeping the tip of the wire facing toward the lateral side the wire negotiated the microchannel present laterally and the lesion was crossed, predilated and successful coronary intervention was accomplished with Thrombolysis in Myocardial Infarction (TIMI) III flow. Our case is an interesting technique of guide wire negotiation in the presence of large dissection flap in acute coronary syndrome. Our case is also a rare illustration of a large spontaneous coronary dissection in an alcoholic. |
| format | Article |
| id | doaj-art-837f5e01f75d475eb0fcb6cbb74ff97b |
| institution | Kabale University |
| issn | 2321-449X 2321-6638 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Heart India |
| spelling | doaj-art-837f5e01f75d475eb0fcb6cbb74ff97b2025-01-08T12:24:23ZengWolters Kluwer Medknow PublicationsHeart India2321-449X2321-66382024-12-0112317017310.4103/heartindia.heartindia_19_24Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique”Debasish DasSatyapriya MohantyAbhinav KumarAnindya BanerjeePranjit DebSubash PramanikWe present a rare case of revascularization of right coronary artery long flap dissection with novel prolapsing knuckle wire technique as the wire was repeatedly entering into the large medial dissection flap rendering the forward advancement of the wire impossible to cross the lesion. We negotiated the wire gently into the bottom of the dissection flap and pushed the wire gently so that the wire will ascend up and form a U loop inside the dissection flap. Further gentle advancement of the wire prolapsed the wire tip into the main lumen mimicking the fact that the dissection flap vomited out the wire into the main lumen. Keeping the tip of the wire in the main lumen, gentle pulling of the wire straightened the U loop, wire came out of the false lumen and gentle forward push with torque keeping the tip of the wire facing toward the lateral side the wire negotiated the microchannel present laterally and the lesion was crossed, predilated and successful coronary intervention was accomplished with Thrombolysis in Myocardial Infarction (TIMI) III flow. Our case is an interesting technique of guide wire negotiation in the presence of large dissection flap in acute coronary syndrome. Our case is also a rare illustration of a large spontaneous coronary dissection in an alcoholic.https://journals.lww.com/10.4103/heartindia.heartindia_19_24knuckle wire techniqueprolapsingrevascularizationright coronary artery |
| spellingShingle | Debasish Das Satyapriya Mohanty Abhinav Kumar Anindya Banerjee Pranjit Deb Subash Pramanik Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” Heart India knuckle wire technique prolapsing revascularization right coronary artery |
| title | Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” |
| title_full | Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” |
| title_fullStr | Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” |
| title_full_unstemmed | Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” |
| title_short | Revascularization of an acute right coronary artery long flap dissection with “Prolapsing knuckle wire technique” |
| title_sort | revascularization of an acute right coronary artery long flap dissection with prolapsing knuckle wire technique |
| topic | knuckle wire technique prolapsing revascularization right coronary artery |
| url | https://journals.lww.com/10.4103/heartindia.heartindia_19_24 |
| work_keys_str_mv | AT debasishdas revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique AT satyapriyamohanty revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique AT abhinavkumar revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique AT anindyabanerjee revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique AT pranjitdeb revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique AT subashpramanik revascularizationofanacuterightcoronaryarterylongflapdissectionwithprolapsingknucklewiretechnique |