Changing the guiding catheter over the coronary wire: a simple (and cheap) technique to get out of trouble.

摘要

During acute myocardial infarction (MI), the culprit lesion is usually composed of thrombus and soft plaque. Sometimes, calcification can be present. A patient with acute MI, due to sub-occlusion of the ostial right coronary artery, underwent primary percutaneous intervention. The procedure was complicated by severe dissection after balloon inflation. The use of standard materials did not allow stent passage, due to an underestimated severe calcification. To provide better support, we changed the guiding catheter for a more supportive one over the coronary guidewire, left in place to avoid rewiring the false lumen.This technique allowed successful stent deployment.