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BACKGROUND: Cardiac tamponade or pericardial tamponade (PT) can be a complication following invasive cardiac procedures. METHODS: Patients who underwent various procedures in the cardiac catheterization lab (viz. coronary interventions) were identified using the International Classification of Diseases, Ninth and Tenth Edition, Clinical Modification (International classification of diseases [ICD]-9-Clinical modification [CM] and ICD-10-CM, respectively) from the Nationwide Inpatient Sample (NIS) database. Patient demographics, presence of comorbidities, PT-related events, and in-hospital death were also abstracted from the NIS database. RESULTS: The frequency of PT-related events in the patients undergoing CI from 2010 to 2017 ranged from 3.3% to 8.4%. Combined in-hospital mortality/morbidity of PT-related events were higher with increasing age (odds ratio [OR] [95% CI]: chronic total occlusion (CTO) = 1.19 [1.10-1.29]; acute coronary syndrome (ACS) = 1.21 [1.11-1.33], both p < 0.0001) and female sex (OR [95%CI]: CTO = 1.70 [1.45-2.00]; ACS = 1.72 [1.44-2.06], both p < 0.0001). In-hospital mortality related to PT-related events was found to be 8.5% for coronary procedures. In-hospital mortality was highest amongst the patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for ACS (ACS vs. non-CTO PTCA vs. CTO PTCA: 15.7% vs. 10.4% and 14.4%, p < 0.0001 and ACS vs. non-CTO PTCA vs. CTO PTCA: 12.1% vs. 8.1% and 5.6%, p = 0.0001, respectively). CONCLUSIONS: In the real-world setting, PT-related events in CI were found to be 3.3%-8.4%, with in-hospital mortality of 8.5%. The patients undergoing PTCA for ACS were found to have highest mortality. Older patients undergoing CTO PTCA independently predicted higher mortality.

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PURPOSE: Chronic mesenteric ischemia (CMI) is a rare disease that progresses with acute mesenteric ischemia, along with high mortality. How to choose the appropriate surgical method and the artery which should be opened first is the key to the treatment. CASE REPORT: In this study, we successively used vascular bypass and endovascular therapy to treat a case of complex chronic mesenteric ischemia. CONCLUSION: For mesenteric ischemic disease, the superior mesenteric artery (SMA) should be opened preferentially. Arterial bypass or interventional therapy can be used, or both can be combined, to finally achieve the purpose of treatment.

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BACKGROUND: The history of bypass surgery for coronary arteries and subsequent coronary angioplasty is a crucial and vital issue for patients with acute coronary syndrome (ACS). This study aims to investigate and compare the occurrence of cardiovascular events in patients with a history of Coronary Artery Bypass Grafting (CABG) versus those without such a history, specifically focusing on individuals diagnosed with ACS. MATERIALS AND METHODS: This cohort study was conducted at Madani Hospital in Tabriz, Iran. Patients diagnosed with ACS who were hospitalized and underwent Percutaneous Coronary Intervention (PCI) from the beginning of 2018 to the beginning of 2020 were included. The records for follow-up regarding mortality and cardiovascular events were documented for the next three years (2020 to 2023). Subsequently, patients were categorized into two groups: those with a history of CABG and those without a history of CABG. Patients of each study group were divided into two groups: ST-segment elevation acute coronary syndrome (STEA)CS/primary PCI and non-ST-segment elevation acute coronary syndrome (NSTEACS)/PCI, a total of approximately 473 cases were collected. The study groups were compared in terms of in-hospital and long-term cardiovascular events as well as other clinical outcomes. RESULTS: A comparison of hospital and long-term events between the CABG group and the control group demonstrated a significant difference only in cases of recurrent myocardial infarction (MI)/ACS in long-term events (P=0.001). Additionally, comparing hospital and long-term events in the CABG group and the STEACS/NSTEACS control group revealed a significant difference only in cases of recurrent MI/ACS in long-term events (P=0.05). CONCLUSION: Patients with a history of CABG may face a higher risk of cardiovascular events, especially in recurrent MI/ACS. A thorough examination and closer monitoring of this patient group are needed to ensure improvement and mitigate the risks associated with potential complications arising from previous CABG surgeries.

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BACKGROUND: Excimer laser coronary angioplasty (ELCA) has evolved as a pivotal element in percutaneous coronary intervention (PCI), significantly influencing procedural efficacy and safety. This mini-narrative review explores ELCA's applications, focusing on its efficacy and clinical outcomes. BODY: A search of major databases identified studies from ELCA's inception. Inclusion criteria encompassed diverse study designs exploring ELCA in coronary interventions, with rigorous data extraction ensuring accuracy and completeness. A narrative synthesis presented key findings across studies. ELCA demonstrated promising outcomes compared to traditional PCI and stent placement. Reduced reperfusion time, enhanced microcirculation, and lower postoperative major adverse cardiac events (MACE) rates highlighted its efficacy. Improved vascular and lumen dynamics, plaque modification, and successful treatment of complex lesions showcased its versatility. Quality of life enhancements positively impacted long-term recovery, particularly in acute coronary syndrome (ACS) cases. ELCA's success in challenging scenarios and its role in refining in-stent restenosis (ISR) treatment indicated broader applications. Despite limitations in some studies, ELCA presented a favorable safety profile. CONCLUSION: The review underscores ELCA's dynamic role in coronary interventions, offering a promising tool for enhancing procedural outcomes. Clinical implications include improved reperfusion, adaptability in complex lesions, and potential long-term benefits for ACS patients. While integration into routine practice requires careful consideration, ELCA's positive outcomes encourage further exploration and innovation in interventional cardiology.

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An 81-year-old man with asymptomatic severe carotid artery stenosis and symptomatic iliac artery stenosis underwent simultaneous carotid artery stenting (CAS) and iliac artery percutaneous transluminal angioplasty and stenting. The procedure involved transfemoral access, balloon angioplasty, and stenting of the right iliac artery, followed by CAS of the right carotid artery. Similar procedures were performed later on the left iliac and carotid arteries. The patient was discharged with no neurological deficits and remained asymptomatic at a six-month follow-up. Simultaneous CAS and iliac artery stenting were feasible and effective in patients with concurrent severe carotid and iliac artery stenosis, providing a comprehensive revascularization strategy for patients with complex atherosclerotic disease.

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Background and aim: High-dose statin therapy before percutaneous coronary intervention (PCI) is thought to reduce the occurrence of Peri-procedural Myocardial Infarction (PPMI), which is associated with increased mortality and prolonged hospitalization, especially in statin naïve patients. This study aims to investigate the effect of rosuvastatin loading dose on PPMI and major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing elective PCI, considering their statin use. Methods: One hundred sixty-five patients with stable coronary artery disease (CAD) without heart failure (HF) or chronic kidney disease (CKD) were included in the study. They were divided into two groups: patients already on statin treatment (n:126) and statin naive patients (n:39). Both groups were randomly assigned to high-dose (40 mg) rosuvastatin (n:86) or a non- loading dose group (n:79). The primary endpoint was the incidence of PPMI, and the secondary endpoint was MACCE. Results: The mean age of study population was 59 ± 9.4 years with 77% being male (n = 127). The median follow-up (FU) time was 368 day. Thirty patients were diagnosed with PPMI after PCI (19 in the high-dose group and 11 in the no-loading-dose group). Meanwhile, less than half of study population (77 patients, 46.7%) had complex lesion type (B2, C) and 88 of those (53.3%) had simple lesion type (A, B1). PPMI was observed more frequently in statin-naive patients (23%) than in statin users (17%), although the difference was not statistically significant. Only two patients (1.2%) experienced MACCE during the FU period. One of these patients, who had a type C lesion, belonged to group A2 and underwent Target Vessel Revascularization (TVR) on the 391st day. The other patient, with a type B1 lesion, was in group A1 and was hospitalized due to Acute Coronary Syndrome (ACS) on the 40th day of FU. Conclusions: Pre-procedural administration of high dose rosuvastatin in patients with stable coronary artery disease did not decrease PPMI, independent of chronic statin use.

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The IMPELLA 5.5 (Abiomed Inc., Danvers, Massachusetts, United States) is a catheter-based, micro-axial blood pump designed to enhance organ perfusion in patients with cardiogenic shock. Despite its superior hemodynamic support, vascular complications are a significant concern, with many patients needing to discontinue IMPELLA therapy due to these issues. Patients may even require surgical intervention to address device-related vascular injuries. The IMPELLA 5.5 implantation in vessels with severe calcification is particularly associated with complications such as vascular calcification, stenosis, vascular tortuosity, and the use of larger sheaths are risk factors following endovascular therapy and IMPELLA implantation. In this report, we present a case of severe calcification in the right subclavian artery, in which the IMPELLA 5.5 was lodged. The calcifications protruded into the vascular lumen, becoming lodged between the IMPELLA motor and the cannula, complicating extraction despite the vessel having sufficient diameter. We successfully removed the device using a balloon dilation technique, ensuring safe extraction. No vascular complications such as pseudoaneurysm or dissection were observed in the right subclavian artery one month after extraction. This case highlights a potential approach for managing similar complications and vascular access for IMPELLA insertion.

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With newly created therapy devices and cutting-edge diagnostic techniques, we successfully diagnosed and treated subclavian steal syndrome in this case report. This case report is complemented by a literature review that examines the current state of knowledge about diagnostic and treatment options. The patient reported pain and numbness in his left upper arm when raising his arm above his head. On clinical examination, he had good left radial and ulnar pulses while in a sitting position; however, he had absent left ulnar pulses when he raised his hand above his head. Angiography revealed retrograde perfusion of the left vertebral artery and nearly complete occlusion of the ostium of the left subclavian artery. The patient underwent angioplasty and stenting. Immediately after the procedure, the patient reported a reduction in the pain and numbness in his left upper limb by 50%, which completely disappeared at his routine follow-up after one month. The patient was completely asymptomatic during follow-up and had no signs of neurological deficit.

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PURPOSE: This study retrospectively investigated whether infarction in specific Alberta Stroke Program Early CT Score (ASPECTS) regions is associated with clinical outcome in patients with symptomatic non-acute internal carotid or middle cerebral artery occlusion who underwent endovascular recanalisation (ER). METHODS: Preoperative ASPECTS and region of infarction were recorded before recanalisation. Clinical outcome was evaluated 90 days after the procedure using the modified Rankin Scale; a score>2 was defined as poor outcome. Secondary outcomes included postprocedural cerebral oedema, intracranial haemorrhage (ICH) and symptomatic ICH. RESULTS: Among the 86 patients included, 90-day outcome was poor in 30 (34.9%) and 40 experienced cerebral oedema (46.5%). Multivariate logistic regression models showed that lenticular nucleus infarction (OR 19.61-26.00, p<0.05), admission diastolic blood pressure (OR 1.07-1.08, p<0.05), preprocedural National Institutes of Health Stroke Scale (OR 1.96-2.05, p<0.001) and haemorrhagic transformation (OR 14.99-18.81, p<0.05) were independent predictors of poor 90-day outcome. The area under the receiver operating characteristic curve for lenticular nucleus infarction as a predictor of poor outcome was 0.73. M2 region infarction (OR 26.07, p<0.001) and low American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral circulation grade (OR 0.16, p=0.001) were independent predictors of postprocedural cerebral oedema. The area under the receiver operating characteristic curve for M2 region infarction as a predictor of cerebral oedema was 0.64. Region of infarction did not significantly differ between patients with and without postprocedural ICH or symptomatic ICH. CONCLUSIONS: Lenticular nucleus and M2 region infarction were independent predictors of poor 90-day outcome and postprocedural cerebral oedema, respectively, in patients with non-acute anterior circulation large artery occlusion who underwent ER.

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There has been a rapid expansion in centers performing balloon pulmonary angioplasty (BPA) and pulmonary thromboendarterectomy (PTE) for chronic thromboembolic pulmonary hypertension (CTEPH). The purpose of this scoping review was to identify cardiothoracic imaging predictors of outcomes and to identify gaps to address in future work. A scoping review was conducted using the framework outlined by Arksey and O'Malley and Levac et al. in MEDLINE and EMBASE. The study protocol was preregistered in OSF Registries and performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. There were 1117 identified studies, including 48 involving pulmonary thromboendarterectomy (n = 25) and balloon pulmonary angioplasty (n = 23). CT was the most common preoperative imaging modality used (n = 21) and CT level of disease was the most reported imaging predictor of outcomes for pulmonary thromboendarterectomy. Although must studies evaluated hemodynamic improvements, imaging was of additional use in predicting clinically significant procedural complications after balloon pulmonary angioplasty, as well as mortality and long-term outcome after pulmonary endarterectomy. Predictors reported in MRI and digital subtraction angiography were less commonly reported and warrant multicenter validation. Cardiothoracic imaging may predict clinically significant outcomes after balloon pulmonary angioplasty and pulmonary thromboendarterectomy. Radiologists involved in the assessment of CTEPH patients should be aware of key predictors and future investigations could focus on multicenter validation and new technologies.

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Background/Objective: Atherosclerosis is becoming increasingly common in modern society. Owing to the increasing number of complex angioplasty procedures, there is an increasing need for training in cases where the risk of periprocedural complications is high. Methods: A procedure was developed to obtain three-dimensional (3D) models and printing of blood vessels. The mechanical and optical properties of the printed materials were also examined. Angioplasty and stent implantation were tested, and the phantom was compared with the clinical data of patients who underwent interventional treatment. Both laser techniques and cone-beam computed tomography of the phantoms were used for comparison. Results: The printed material exhibited mechanical parameters similar to those of blood vessel walls. The refractive index of 1.473 ± 0.002 and high transparency allowed for non-invasive laser examination of the interior of the print. The printed models behaved similarly to human arteries in vivo, allowing training in treatment procedures and considering vessel deformation during the procedure. Models with stents can be analyzed using laser and cone-beam computed tomography to compare stents from different manufacturers. Conclusions: The developed methodology allows for simple and time-efficient production of personalized vessel phantoms.

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In-stent restenosis (ISR) accounts for 10% of percutaneous coronary intervention (PCI) in the United States. Paclitaxel-coated balloons (PCBs) have been evaluated as a therapy for coronary ISR in multiple randomized controlled trials (RCTs). We searched PubMed/MEDLINE, Cochrane Library, and ClinicalTrials.gov (from inception to April 1, 2024) for RCTs evaluating PCBs versus uncoated balloon angioplasty (BA) in patients with coronary ISR. The outcomes of interest were target lesion revascularization (TLR), major adverse cardiovascular events (MACEs), all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and stent thrombosis. We pooled the estimates using an inverse variance random-effects model. The effect sizes were reported as risk ratio (RR) with 95% confidence interval (CI). A total of 6 RCTs with 1,343 patients were included. At a follow-up ranging from 6 to 12 months from randomization, the use of PCBs was associated with a statistically significant decrease in TLR (RR 0.28, 95% CI 0.11 to 0.68) and MACE (RR 0.35, 95% CI 0.20 to 0.64) compared with BA for coronary ISR. However, there was no significant difference in risk between PCBs and BA in terms of all-cause mortality (RR 0.56, 95% CI 0.14 to 2.31), cardiovascular mortality (RR 0.61, 95% CI 0.02 to 16.85), MI (RR 0.60, 95% CI 0.27 to 1.31), and stent thrombosis (RR 0.13, 95% CI 0.00 to 5.06). In conclusion, this meta-analysis suggests that PCBs compared with uncoated BA for the treatment of coronary ISR at intermediate-term follow-up of 1 year were associated with a significant decrease in TLR and MACE without any difference in mortality, MI, or stent thrombosis.

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PURPOSE: To compare primary patency after angioplasty with drug-coated balloon (DCB)-Passeo-18Lux, BIOTRONIK versus uncoated balloon in dysfunctional peripheral vascular access (PVA) for hemodialysis. MATERIAL AND METHODS: A total of 133 patients from four hospitals were randomized to receive DCB or plain old balloon angioplasty (POBA) after satisfactory treatment (residual stenosis <30%) with high pressure balloon (HPB). The primary endpoint was clinical patency of PVA 2 years after angioplasty. Secondary endpoints included the relationship between the location of stenosis and patency and also, other covariates. Mortality at 2 years was compared between both groups. RESULTS: Patency measured in days after angioplasty was higher in fistulae dilated with DCB than HPB. Kaplan-Meier survival curves showed the next percent of success (free time restenosis) after DCB versus POBA at 6 months-77.1% versus 58.2% (160.41-143.72 days until restenosis), 12 months-51.4% versus 44.3% (274.1-237.23), 18 months-38.6% versus 38% (350.74-305.18), and 24 months-37.1% versus 30.4% (419.04-369.1). At 6 months, this difference was statistically significant (p = 0.018), but not at 12 (p = 0.225), 18 (p = 0.471), or 24 months (p = 0.236). Mortality was similar in both groups. CONCLUSIONS: DCB angioplasty resulted in superior target lesion primary patency (TLPP)-free survival at 6 months of follow-up. No significant improvements in TLPP-free survival long term were observed. Mortality observed at 1 and 2 years was similar in DCB and POBA: there was no significant difference, and a safety study demonstrated no difference between the two groups (complications and mortality): DCB is safe to use in stenosis treatment in patients who are PVA carriers. LEVEL OF EVIDENCE: Level Ia, therapeutic study, RCT. EBM ratings will be based on a scale of 1-5.

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Controversy still exists regarding how much the inflow arterial percutaneous transluminal angioplasty (PTA) contributed to maintaining fistula function for hemodialysis. We aimed to analyze patency and risk factors after inflow arterial PTA. Hemodialysis patients with inflow arterial primary stenosis who were admitted to our institution from January 2017 to December 2022 were examined. One group had arterial-venous fistula with inflow artery stenosis alone (AVF + iAS) and another group had AVF with inflow artery stenosis and any vein stenosis (AVF + iAS + VS). The characteristics of patients, stenotic lesions, and PTA procedures were recorded. Kaplan-Meier analysis was used to compare primary patency, assisted primary patency, and secondary patency in the two groups. Cox proportional hazard analysis was used to identify risk factors associated with patency. We examined 213 patients, 53 in the AVF + iAS group (51 radial arterial stenosis and 2 ulnar arterial stenosis) and 160 in the AVF + iAS + VS group (159 radial arterial stenosis and 1 ulnar arterial stenosis). Kaplan-Meier analysis indicated the AVF + iAS group had better primary patency and assisted primary patency (both P < 0.05), but the groups had similar secondary patency. Cox proportional hazard analysis indicated that none of the analyzed clinical and biochemical indexes had clinically meaningful effects on primary patency, assisted primary patency, or secondary patency in either group. The patency and safety after PTA for inflow arterial stenosis were satisfactory, and none of the examined risk factors had a major clinical impact on patency. We recommend PTA as treatment for inflow stenosis of an AVF.

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For patients with repeated stenosis of autologous arteriovenous fistula, percutaneous transluminal angioplasty (PTA) or bare metal stent placement had limited efficacy. Rapamycin was reported to inhibit neointimal hyperplasia and keep blood vessels patent. In this study, we reported a case with refractory stenosis, i.e., a short duration of patency maintenance after each repeated PTA, which was treated with a rapamycin-eluting stent (RES). The RES extended the patency duration from 4 to 5 months on average to 14 months. The stent was used to maintain dialysis for over 30 months. RES may be an effective way to treat refractory stenosis and salvage limited vascular resources.

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The frequency of percutaneous transluminal angioplasty (PTA) procedures has substantially increased, but its effect on vascular access recreation (VAR) remains inconclusive. We conducted a population-based retrospective analysis of Taiwan hemodialysis (HD) centers from 2004 to 2012. Data was accumulated into center-level characteristics, including patients' demographics, baseline characteristics, PTA procedures, and VAR. Center-level characteristics were summarized annually using appropriate measures. A mixed model assessed the association between PTA frequency and VAR rates, considering within-center correlation and adjusting for potential confounders. A total of 82,005 patients (mean age 62.7 ± 13.9 years, 50.5% male, 48.5% with diabetes mellitus) from 820 HD centers were analyzed. From 2004 to 2012, PTA frequency significantly increased from 1.24 to 3.23 per 1000 HD sessions, while VAR rates did not decline as expected (0.5-0.8 per 1000 HD sessions). Compared with the HD centers of infrequent use of PTA (annual lowest quartile, range 0.39-1.20 per 1000 HD sessions), the ones of frequent use (annual highest quartile, range 2.52-5.10 per 1000 HD sessions) didn't have lower VAR (range 0.54-0.99 vs. 0.50-0.91 per 1000 HD sessions, respectively). After controlling the potential confounders, the HD centers' PTA rates were not significantly associated with lower VAR rates (- 2.6, 95% confidence interval: - 30.3; 25.0, p = 0.85). Frequent use of PTA does not seem to improve VA patency at the center level, with no significant association identified with lower VAR. The indication of PTA in daily practice should be re-evaluated in terms of its efficiency in lowering VAR.

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For endovascular treatment of below-the-knee (BTK) peripheral artery disease (PAD), independently adjudicated real-world outcomes comparing non-stent-based balloon angioplasty (percutaneous transluminal angioplasty) and adjunctive treatments with or without a concomitant ipsilateral femoropopliteal (FP) artery intervention are scarce. A total of 1,060 patients from the multicenter XLPAD registry who underwent non-stent-based BTK PAD intervention between 2006 and 2021 were included. The primary outcome was the 1-year incidence of major adverse limb events (MALEs), a composite of all-cause death, any amputation, or clinically driven repeat revascularization. A total of 566 patients underwent BTK and 494 BTK + FP interventions; 72% were men, with a mean age of 68.4 ± 10.9 years. Diabetes mellitus was more prevalent in the BTK-only group (76.5% vs 69%, p = 0.006). Mean Rutherford class was 4.2 ± 1.18; chronic limb-threatening ischemia was more frequent in the BTK group (55.3% vs 49%, p = 0.040). Moderate to severe calcification was more frequent in the BTK + FP group (21.2% vs 27.1%, p = 0.024), as was lesion length (110.6 ± 77.3 vs 135.4 ± 86.3 mm, p <0.001). Nearly 81% of lesions were treated with percutaneous transluminal angioplasty. Drug-coated balloon (1.6% vs 14%, p <0.001) and atherectomy (38% vs 58.5%, p <0.001) use was more frequent in the BTK + FP group. The rate of procedural success was higher in the BTK + FP group (86% vs 91%, p = 0.009), with amputation being the most common complication at 3.3% within 30 days after the procedure. The rates of 1-year MALE (21.2% vs 22.3%, p = 0.675) and mortality (4.6% vs 3.4%, p = 0.3) were similar between the BTK and BTK + FP groups. Nonstent treatment for BTK PAD with concomitant FP intervention leads to high procedural success and similar rates of 1-year MALE compared with isolated BTK intervention. Condensed Abstract: The vast majority of below-the-knee (BTK) peripheral artery disease (PAD) interventions are performed with balloon angioplasty. Presence of inflow femoropopliteal PAD in patients who undergo BTK interventions can affect the outcome of the procedure. This report explores immediate procedural success and major adverse limb events at 1 year after balloon angioplasty treatment for isolated BTK PAD and in patients who underwent an additional femoropopliteal PAD intervention.

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BACKGROUND: Cognard type IIa+b dural arteriovenous fistulas (DAVFs) in the lateral sinuses are often complicated with venous sinus obstruction and accompanied by clinical symptoms and a risk of hemorrhage. The purpose of this study was to assess venous sinus stenting as a viable alternative treatment in complex lateral sinus DAVFs and examine its efficacy and safety. METHODS: We retrospectively examined patients diagnosed with type IIa+b DAVF in the transverse or sigmoid sinus with associated venous sinus occlusion who were treated via stent placement between April 2017 and June 2019. RESULTS: Six patients were included in this study. Three patients had DAVFs in both the transverse and sigmoid sinuses, two in the transverse sinus and confluence of sinuses, and one in the transverse sinus. The most common symptoms were headache, dizziness, and limb weakness. At the last follow-up, three patients had significant improvement, and three were asymptomatic. Angiograms performed immediately after the surgery showed restoration of the anterograde venous drainage in all patients. According to the follow-up angiography results, two DAVFs were completely obliterated, and four remained as stable type I DAVFs. Most patients had satisfactory venous sinus drainage, except one who had in-stent stenosis. CONCLUSIONS: Stent placement can restore sinus patency, improve clinical symptoms, and decrease intracranial hemorrhage risk. This approach may be an effective option for treating type IIa+b lateral DAVFs complicated by sinus occlusion.

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Iatrogenic coronary dissections are rare but potentially serious. Their management is complex, particularly if the dissection occurs without an angioplasty guide in the arterial lumen. In this context, angiography alone is insufficient, and endocoronary imaging is essential (using optical coherence or IVUS) to guide angioplasty when necessary (guide in the true lumen, coverage of the tear). We report here the case of an iatrogenic dissection of the right coronary artery treated with OFDI guiding.

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