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True Lumen Identification in Dissection: Role of IVUS

Author : E.N. Aisyah, M.Y. Assegaf
Upload Date : 19-04-2018

Coronary dissection is an uncommon yet potentially devastating complication of Percutaneous coronary intervention (PCI). Coronary dissection during catheterization can be caused by the catheter, guide wire, contrast injection, or any device inserted into a coronary artery.  Dissection of the coronary artery results in separation of the layers of the arterial wall, creating a false lumen.  Hemorrhage into the false lumen can impinge upon the true lumen of the coronary artery, impairing the blood flow and causing myocardial ischemia, infarction, sudden death, cardiogenic shock, or pericardial tamponade. The existence of true lumen and false lumen can provide its own challenge to the management of coronary dissection. Intravascular ultrasound (IVUS), is an invasive catheter based technology that acquires detailed imaging of the arterial tree. It is able to determine information such as lumen and vessel diameter, anatomic information on the location of other structures, and further pathologic discrimination between different types of atherosclerotic plaque. In this case, we report 54 years old, female patient with coronary dissection. PCI with drug-eluting stent implantation was performed on the basis of IVUS imaging. IVUS imaging was useful diagnostically and for navigating the guidewire into the true lumen, despite a good angiographic appearance.

KEYWORDS : coronary dissection, IVUS, Intravascular ultrasound, PCI


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