Successful stenting on tortuous coronary artery with accordion phenomenon:Strategy - A case report

Guidewire manipulation through tortuosities is difficult. Straightening a t ortuous coronary artery by using a stiff guidewire has been recognized to i nduce vessel wall shortening referred to as an "accordion phenomenon." With inappropriate identification as dissection or thrombus formation, the risk of performing unnecessary dilation at the pseudo-narrowing site exists. Th e authors describe here two cases showing the accordion phenomenon induced by a stiff guidewire during successful stenting at a tortuous right coronar y artery. In another case, the authors experienced an "accordion phenomenon " at the proximal edge of the Palmaz-Schatz stent implanted in a tortuous r ight coronary artery. The stent edge was better positioned at the straight portion than at the contour portion in a tortuous coronary artery.