Author + information
- Received September 15, 2008
- Accepted September 29, 2008
- Published online April 1, 2009.
- Carl Schultz, MD, PhD,
- Martin van der Ent, MD, PhD,
- Patrick W. Serruys, MD, PhD⁎ ( and )
- Evelyn Regar, MD, PhD
- ↵⁎Reprint requests and correspondence:
Dr. Patrick W. Serruys, Department of Interventional Cardiology, Erasmus Medical Center, Thoraxcenter, Ba583, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
A woman, age 50 years, with debilitating angina, infero-lateral reversible ischemia, and a chronic occlusion of the circumflex artery was treated by crossing with a guidewire (GW) into the contrast-filled distal true lumen (TL) (Figs. 1A and 1B).
After pre-dilation, optical coherence tomography (0.019-inch image wire; Lightlab Imaging, Boston, Massachusetts) showed the GW parallel to the imaging wire casting a shadow (white lines) (Fig. 2). Proximally (Fig. 2C) the GW was in the TL separated by a dissection flap (arrows) from the false lumen (FL). Mid-vessel (Fig. 2B) the GW was in an enlarged FL with the TL barely visible (dotted green line). Distally (Fig. 2A) the TL was obliterated. Correction of GW position and stent placement resulted in Thrombolysis In Myocardial Infarction flow grade 3 and good runoff (Fig. 1C).
- Received September 15, 2008.
- Accepted September 29, 2008.
- American College of Cardiology Foundation