Bailout technique to rescue the abruptly occluded side branch with collapsed true lumen after main vessel stenting

Abstract

Guidewire recrossing into the abruptly occluded side branch (SB) after main vessel (MV) stenting in the coronary bifurcation is difficult, particularly if the SB has a dissection because the true lumen of SB is collapsed by a hematoma and the second guidewire easily goes into the false lumen. This paper reports a bailout technique to rescue the occluded SB that was complicated by a hematoma because of an unsuccessful guidewire recrossing after MV stenting using a small balloon dilation in the collapsed SB true lumen behind the stent strut and wire penetration.

Imaging behind occluded areas with an iatrogenic perforated balloon: A safe, practical, and simple new method of visualizing the distal lumen in total occlusion

“…Most of the time, decisions regarding balloon dilatation of the lesion are based on the discretion of the operator. This condition may sometimes cause vascular dissection, rupture, or ballooning of the false lumen …”