THE CRUMPLED CORONARY - AN ENIGMA OF ARTERIOGRAPHIC PSEUDOPATHOLOGY AND ITS POTENTIAL FOR MISINTERPRETATION

A series of angioPlasty cases is presented in which dynamic alteration s in coronary artery configuration developed. These changes were sugge stive of extensive, complex dissections. Several common features emerg ed in these cases of which interventional cardiologists should be awar e. These features included complex vessel morphology (tortuous segment s, anomalous takeoffs, and complex stenoses) and the use of certain ty pes of PTCA hardware (Amplatz guiding catheters and 0.018-inch wires). This phenomenon, termed pseudo narrowing, remains largely unrecognize d. Identification of these characteristics and employment of proper ma nagement strategies will ensure a good outcome in these situations whe n they arise. (C) 1994 Wiley-Liss, Inc.