Successful Percutaneous Coronary Intervention Using Intravascular Ultrasound-Guided Rewiring Technique in a Case of Spontaneous Coronary Artery Dissection Involving Left Main Bifurcation

Figure 1

Coronary angiography and percutaneous coronary intervention. (a) Left coronary angiography (right anterior oblique caudal view) revealed a dissection at the proximal site of the LAD extending from the LMT, suggestive of type 1 spontaneous coronary artery dissection (red arrow). (b) Coronary blood flow of the LAD was impaired after coronary angiography. (c) The IVUS-guided rewiring technique was performed, and the third guide wire (purple arrow) was inserted from the true lumen of the LCX to the true lumen of the LAD by referring to the IVUS findings of the dissected segment. (d and e) A drug-eluting stent was deployed to cover the dissected segment. (f) Final coronary angiography revealed acceptable results. LMT: left main trunk; LAD: left anterior descending artery; LCX: left circumflex artery; IVUS: intravascular ultrasound.

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