EuroPCR2026-images-98316-curious-case-crooked-artery

Concertina effect or Accordion effect is a crumpling effect in vessel seen because of increased tortuosity of the vessel or usage of stiff guidewire during procedure.Beaded coronaries, is quite a fascinating unique event that can occur while doing percutaneous intervention. There is no definite percentage in literature about how frequent it is.(1)It is basically dependent on the tortuosity of the vessel and kind of percutaneous interventional wires being used. The stiffer the wire, the more chances of invagination of the tissue thereby causing a crumpled appearance. Straightening of the tortuous coronary artery by a ‘‘stiff’’guide wire results in invagination and beading of vessel. Whether there is a role for spasm 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effect is unknown.There is nothing in the literature to support or refute this.(2)In most cases, as soon as the wire is withdrawn, this effect disappears.References:1. Kim MS, Kim CJ, Heo SB, Cho EJ, Park JH, Choi GS, et al. Two cases of coronary pseudo-lesion induced in the left circumflex artery and the right coronary artery by the angioplasty guide-wire. KoreanCirc J 2004;34(8):799–803, Korean.2. Olivier M, Michalis H, Ntalianis Argyris, Giovanna S, Bernard D.The accordion phenomenon lesson from a movie. Circulation2008;118:e677–8.3. Tsutsumi M, Kazekawa K, Onizuka M, Aikawa H, Iko M,Kodama T, et al. Accordion effect during carotid artery stenting:report of two cases and review of the literature. Neuroradiology2007;49(7):567–70.4. Quinn SF, Kim J, Sheley RC, Frankhouse JH. ‘‘Accordion’’deformity of a tortuous external iliac artery after stent-graftplacement. J Endovasc Ther 2001;8(1):93–8.

 

Concertina effect or Accordion effect is a crumpling effect in vessel seen because of increased tortuosity of the vessel or usage of stiff guidewire during procedure.Beaded coronaries, is quite a fascinating unique event that can occur while doing percutaneous intervention. There is no definite percentage in literature about how frequent it is.(1)It is basically dependent on the tortuosity of the vessel and kind of percutaneous interventional wires being used. The stiffer the wire, the more chances of invagination of the tissue thereby causing a crumpled appearance. Straightening of the tortuous coronary artery by a ‘‘stiff’’guide wire results in invagination and beading of vessel. Whether there is a role for spasm 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.References:1. Kim MS, Kim CJ, Heo SB, Cho EJ, Park JH, Choi GS, et al. Two cases of coronary pseudo-lesion induced in the left circumflex artery and the right coronary artery by the angioplasty guide-wire. KoreanCirc J 2004;34(8):799–803, Korean.2. Olivier M, Michalis H, Ntalianis Argyris, Giovanna S, Bernard D.The accordion phenomenon lesson from a movie. Circulation2008;118:e677–8.3. Tsutsumi M, Kazekawa K, Onizuka M, Aikawa H, Iko M,Kodama T, et al. Accordion effect during carotid artery stenting:report of two cases and review of the literature. Neuroradiology2007;49(7):567–70.4. Quinn SF, Kim J, Sheley RC, Frankhouse JH. ‘‘Accordion’’deformity of a tortuous external iliac artery after stent-graftplacement. J Endovasc Ther 2001;8(1):93–8.