Multivessel Spasm During Coronary and Peripheral Angiography
Multivessel Spasm During Coronary and Peripheral Angiography
We describe a case in which multiple coronary artery spasms and iliac artery spasm mimicked diffuse atherosclerosis, affecting multiple vascular beds during combined coronary and peripheral angiogram in a single sitting. To our knowledge, this is the first report of such a phenomenon in which multiple coronary and peripheral arteries were simultaneously involved. Angio-graphers and interventionists should be aware of this rare phenomenon, since misdiagnosing such pseudo-lesions as fixed stenoses may result in unnecessary interventions.
Artifactual lesions resulting from arterial spasm may occur during angiography or angioplasty. Whereas arterial spasm may occur spontaneously or in response to chemical agents, the term "pseudo-lesion" has been used to describe artifactual lesions or arterial spasm mechanically induced by catheters, guidewires and angioplasty balloons. The mechanism is due to straightening or distortion leading to "accordion effect" of a vessel's curvature. Pseudo-lesion and arterial spasm involving the coronary artery and peripheral artery have been reported individually in the literature. We report a case in which simultaneous multi-vessel coronary spasm involving the left anterior descending coronary artery (LAD) and right coronary artery (RCA), and pseudo-lesion involving the right external iliac artery (EIA) mimicked fixed obstructions during combined coronary and peripheral angiography in the same sitting.
We describe a case in which multiple coronary artery spasms and iliac artery spasm mimicked diffuse atherosclerosis, affecting multiple vascular beds during combined coronary and peripheral angiogram in a single sitting. To our knowledge, this is the first report of such a phenomenon in which multiple coronary and peripheral arteries were simultaneously involved. Angio-graphers and interventionists should be aware of this rare phenomenon, since misdiagnosing such pseudo-lesions as fixed stenoses may result in unnecessary interventions.
Artifactual lesions resulting from arterial spasm may occur during angiography or angioplasty. Whereas arterial spasm may occur spontaneously or in response to chemical agents, the term "pseudo-lesion" has been used to describe artifactual lesions or arterial spasm mechanically induced by catheters, guidewires and angioplasty balloons. The mechanism is due to straightening or distortion leading to "accordion effect" of a vessel's curvature. Pseudo-lesion and arterial spasm involving the coronary artery and peripheral artery have been reported individually in the literature. We report a case in which simultaneous multi-vessel coronary spasm involving the left anterior descending coronary artery (LAD) and right coronary artery (RCA), and pseudo-lesion involving the right external iliac artery (EIA) mimicked fixed obstructions during combined coronary and peripheral angiography in the same sitting.
