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Avoiding the “concertina” effect in PCI of a severely tortuous lad using the Suoh 03 wire: A case report

Dan Pascut

Dan Pascut

Klinikum IngolstadtIngolstadt, Germany
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Pascut, Dan
, 
Ndricim Tobli

Ndricim Tobli

Klinikum IngolstadtIngolstadt, Germany
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Tobli, Ndricim
 und 
Blerim Luani

Blerim Luani

Klinikum IngolstadtIngolstadt, Germany
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Luani, Blerim
  
26. Juni 2025
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Artikel-Kategorie: Case Presentation
Online veröffentlicht: 26. Juni 2025
Seitenbereich: 148 - 151
DOI: https://doi.org/10.2478/rjc-2025-0021
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© 2025 Dan Pascut et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Diagnostic coronary angiography in three standard projections. A: AP cranial view. B: LAO cranial view. C: RAO cranial view. All views show a highly tortuous mid-to-distal LAD with tight tandem lesions in the medial segment.
Diagnostic coronary angiography in three standard projections. A: AP cranial view. B: LAO cranial view. C: RAO cranial view. All views show a highly tortuous mid-to-distal LAD with tight tandem lesions in the medial segment.

Figure 2

Stepwise navigation of a Suoh 03 wire through a tortuous LAD. A–F: Sequential advancement of the Suoh 03 wire shows safe progression through sharp angulations while minimizing trauma to the vessel wall.
Stepwise navigation of a Suoh 03 wire through a tortuous LAD. A–F: Sequential advancement of the Suoh 03 wire shows safe progression through sharp angulations while minimizing trauma to the vessel wall.

Figure 3

PTCA and stenting of the mid-to-distal LAD segment. A–B: Pre-dilatation with balloon angioplasty. C–D: Deployment of two drug-eluting stents. E–F: Final post-dilatation to ensure optimal stent apposition.
PTCA and stenting of the mid-to-distal LAD segment. A–B: Pre-dilatation with balloon angioplasty. C–D: Deployment of two drug-eluting stents. E–F: Final post-dilatation to ensure optimal stent apposition.

Figure 4

Angiographic assessment of the concertina effect. A: After successful wiring, no concertina effect is visible with TIMI III flow. B: After PTCA, the vessel shows minimal concertina effect, still maintaining TIMI III flow.
Angiographic assessment of the concertina effect. A: After successful wiring, no concertina effect is visible with TIMI III flow. B: After PTCA, the vessel shows minimal concertina effect, still maintaining TIMI III flow.

Figure 5

Final angiographic result, showing fully expanded stents. A: AP cranial view. B: RAO cranial view.
Final angiographic result, showing fully expanded stents. A: AP cranial view. B: RAO cranial view.
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Fachgebiete der Zeitschrift:
Medizin, Klinische Medizin, Allgemeinmedizin, Innere Medizin, Kardiologie, Chirurgie, Herzchirurgie, Kinder- und Jugendmedizin, Kinderkardiologie
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