EuroPCR2025-images-A63855RB-Oh my God - What is it with that crumpled coronary: a lesion or a pseudo-lesion?

What does the image depict?
Coronary dissection
Concertina effect
Coronary spasm
Correct! The correct answer is "Concertina effect".
 
Concertina effect or Accordion effect is a vessel crumpling effect observed as a result of increased vessel tortuosity or the use of a stiff guidewire during procedure.
Beaded coronaries are quite a unique and fascinating event that can occur during percutaneous intervention. There is no definite percentage in literature as to its frequency.(1)
 
It basically depends on the tortuosity of the vessel and the type of percutaneous interventional wires used. The stiffer the wire, the greater the risk of invagination of the tissue, thereby resulting in a crumpled appearance. Straightening the tortuous coronary artery using a ‘‘stiff’’guidewire results in invagination and beading of the vessel. Whether spasm plays a role in producing or accentuating this effect is unknown.
 
There is nothing in the literature to support or refute this(2). In most cases, as soon as the wire is withdrawn, this effect disappears.
Most of the cases are found in RCA vessel. This phenomenon has been described in vessels such as carotid and external iliac arteries(3,4).
It should be differentiated from complications like spasm, dissection, rupture, and thrombosis.
 
In some patients, there may be hemodynamic compromise and prompt stent placement, followed by wire retrieval, is of paramount importance.
 
Good try! The correct answer is "Concertina effect".
 
Concertina effect or Accordion effect is a vessel crumpling effect observed as a result of increased vessel tortuosity or the use of a stiff guidewire during procedure.
Beaded coronaries are quite a unique and fascinating event that can occur during percutaneous intervention. There is no definite percentage in literature as to its frequency.(1)
 
It basically depends on the tortuosity of the vessel and the type of percutaneous interventional wires used. The stiffer the wire, the greater the risk of invagination of the tissue, thereby resulting in a crumpled appearance. Straightening the tortuous coronary artery using a ‘‘stiff’’guidewire results in invagination and beading of the vessel. Whether spasm plays a role in producing or accentuating this effect is unknown.
 
There is nothing in the literature to support or refute this(2). In most cases, as soon as the wire is withdrawn, this effect disappears.
Most of the cases are found in RCA vessel. This phenomenon has been described in vessels such as carotid and external iliac arteries(3,4).
It should be differentiated from complications like spasm, dissection, rupture, and thrombosis.
 
In some patients, there may be hemodynamic compromise and prompt stent placement, followed by wire retrieval, is of paramount importance.
 
 
{"name":"EuroPCR2025-images-A63855RB-Oh my God - What is it with that crumpled coronary: a lesion or a pseudo-lesion?", "url":"https://www.poll-maker.com/Q3W6DINV9","txt":"What does the image depict?, Correct! The correct answer is \"Concertina effect\".   Concertina effect or Accordion effect is a vessel crumpling effect observed as a result of increased vessel tortuosity or the use of a stiff guidewire during procedure.Beaded coronaries are quite a unique and fascinating event that can occur during percutaneous intervention. There is no definite percentage in literature as to its frequency.(1)   It basically depends on the tortuosity of the vessel and the type of percutaneous interventional wires used. The stiffer the wire, the greater the risk of invagination of the tissue, thereby resulting in a crumpled appearance. Straightening the tortuous coronary artery using a ‘‘stiff’’guidewire results in invagination and beading of the vessel. Whether spasm plays a role in producing or accentuating this effect is unknown.   There is nothing in the literature to support or refute this(2). In most cases, as soon as the wire is withdrawn, this effect disappears.Most of the cases are found in RCA vessel. This phenomenon has been described in vessels such as carotid and external iliac arteries(3,4).It should be differentiated from complications like spasm, dissection, rupture, and thrombosis.   In some patients, there may be hemodynamic compromise and prompt stent placement, followed by wire retrieval, is of paramount importance., Good try! The correct answer is \"Concertina effect\".   Concertina effect or Accordion effect is a vessel crumpling effect observed as a result of increased vessel tortuosity or the use of a stiff guidewire during procedure.Beaded coronaries are quite a unique and fascinating event that can occur during percutaneous intervention. There is no definite percentage in literature as to its frequency.(1)   It basically depends on the tortuosity of the vessel and the type of percutaneous interventional wires used. The stiffer the wire, the greater the risk of invagination of the tissue, thereby resulting in a crumpled appearance. Straightening the tortuous coronary artery using a ‘‘stiff’’guidewire results in invagination and beading of the vessel. Whether spasm plays a role in producing or accentuating this effect is unknown.   There is nothing in the literature to support or refute this(2). In most cases, as soon as the wire is withdrawn, this effect disappears.Most of the cases are found in RCA vessel. This phenomenon has been described in vessels such as carotid and external iliac arteries(3,4).It should be differentiated from complications like spasm, dissection, rupture, and thrombosis.   In some patients, there may be hemodynamic compromise and prompt stent placement, followed by wire retrieval, is of paramount importance.","img":"https://www.poll-maker.com/3012/images/ogquiz.png"}
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