Iatrogenic coronary dissection causing flush side branch occlusion: use of intravascular ultrasound to reopen vessel

Abstract

Iatrogenic complications present a major challenge to the interventional cardiologist. We describe a case of extensive right coronary artery dissection caused by engagement of a 0.035" guidewire. Attempts to reopen the flush-occluded posterior descending artery using conventional methods were unsuccessful. However, the vessel was successfully restored with the use of intravascular ultrasound guidance and we describe the steps involved in this technique.