Bailout stenting has become an important therapy for acute closure after percutaneous transluminal coronary angioplasty. The case illustrated was a 60-year-old man with crescendo angina. Coronary arteriography revealed significant stenoses in the mid and distal right coronary artery (Fig 1⇓). He underwent balloon angioplasty. The procedure was complicated by a guiding catheter–induced dissection of the proximal vessel, which led to abrupt closure (Fig 2⇓). This dissection was seen to have propagated as far as the distal right coronary artery and necessitated the placement of six coronary stents (five Wiktor stents and one Cook Flexstent). The five Wiktor stents are radiopaque and are visualized in Fig 3⇓. The Cook stent, which was placed at the ostium of the vessel, is radiolucent and thus is not seen. Final angiography showed a widely patent vessel with normal antegrade flow (Fig 4⇓).
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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