What type of study is this?

This is a Human Clinical Trial study (also classified as: Case Report).

August 24, 2025

Successful Tip Detection‐Antegrade Dissection and Re‐Entry for Chronic Iatrogenic Coronary Artery Dissection Using a 6Fr Guiding Catheter: A Technical Challenge Overcome

Key Points

True lumen re-entry was successfully achieved using a combination of advanced imaging and guiding catheter techniques, enhancing procedure efficacy.
Intravascular ultrasound confirmed guidewire placement within the dissection, ensuring accurate intervention during stent deployment, which was ultimately successful.
The approach utilized a 6 Fr guiding catheter along with a specialized low-profile microcatheter, optimizing access and control during the procedure.
This case demonstrates the potential of advanced catheter techniques to effectively manage chronic dissection, suggesting improved patient outcomes in complex scenarios.

Abstract

ABSTRACT A 57‐year‐old man presented with recurrent exertional angina 1 month after an unsuccessful PCI attempt elsewhere. Angiography revealed severe stenosis and a chronic dissection of the posterior lateral artery (PLA). PCI was performed via a 6 Fr right transradial guiding catheter. Initial intravascular ultrasound (IVUS) using OptiCross HD (Boston Scientific; 3.1 Fr outer diameter OD, 20 mm transducer‐to‐tip distance TTD) confirmed guidewire placement in the subintimal space within the extensive chronic dissection. TD‐ADR was successfully performed using the OptiCross HD IVUS and a low‐profile Carnelian MARVEL microcatheter (1.9 Fr OD), both accommodated within the 6 Fr guide. True lumen re‐entry was achieved, followed by balloon dilatation, side branch management, and successful drug‐eluting stent deployment in the main vessel, confirmed by final angiography and IVUS.

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