Coronary pseudo-lesions induced in the left anterior descending and right coronary artery by the angioplasty guide-wire

New lesions appearing during coronary angioplasty may be due to a number of causes including spasm, dissection, embolisation, thrombosis and creation of a pseudo-lesion. The term "coronary pseudo-lesions" has been given to de scribe artefactual lesions occurring during percutaneous transluminal coron ary angioplasty and induced by the angioplasty guide-wire and/or balloon as a result of straightening of the vessel's curvature. No specific treatment is required as they resolve completely on removal of the angioplasty wire. Few modern texts of interventional cardiology contain description of this important phenomenon and we suspect that they pass largely unrecognised. Al l angioplasty operators should become familiar with this complication as fa ilure to do so may lead to inappropriate intervention with attendant increa se in risk to the patient. We report three cases of coronary pseudo-lesion. In two cases affecting the right coronary artery and in the third the left anterior descending coronary artery. Pseudo-lesions affecting the right co ronary artery have been previously reported in the literature however pseud o-lesion affecting the left anterior descending artery has not been describ ed. The possible mechanisms of this phenomenon and its management are discu ssed. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.