Volume 40, Issue 1 pp. 46-51
Feature Topic: Applications of Intravascular Ultrasound

Vessel reconstruction in total coronary occlusions with a long subintimal wire pathway: Use of multiple stents under guidance of intravascular ultrasound

Gerald S. Werner MD

Corresponding Author

Gerald S. Werner MD

Department of Cardiology, Center for Internal Medicine, Georg-August-University Goettingen, Goettingen, Germany

Department of Cardiology, Georg-August-University, Robert-Koch-Str, 40, 37075 Goettingen, GermanySearch for more papers by this author
Jürgen Diedrich

Jürgen Diedrich

Department of Cardiology, Center for Internal Medicine, Georg-August-University Goettingen, Goettingen, Germany

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Karl-Heinz Scholz MD

Karl-Heinz Scholz MD

Department of Cardiology, Center for Internal Medicine, Georg-August-University Goettingen, Goettingen, Germany

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Alexandra Knies

Alexandra Knies

Department of Cardiology, Center for Internal Medicine, Georg-August-University Goettingen, Goettingen, Germany

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Heinrich Kreuzer MD

Heinrich Kreuzer MD

Department of Cardiology, Center for Internal Medicine, Georg-August-University Goettingen, Goettingen, Germany

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Abstract

A frequent cause of failure of the recanalization of a total coronary occlusion is a subintimal pathway of the guide wire. Three cases of occluded right coronary arteries are presented in which a distal reentry into the true vessel lumen was achieved. Intravascular ultrasound was used to locate the exit and reentry of the guide wire, and to plan the position of multiple stents for the coverage of this subintimal pathway. In all cases antegrade flow to the distal coronary bed was restored. Cathet Cardiovasc Diagn 40:46–51, 1997. © 1997 Wiley-Liss, Inc.

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