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

A 62-year-old woman with multiple cardiovascular risk factors presented with Canadian Cardiovascular Society Class III angina. In preparation for scheduled endovascular repair of the abdominal aorta, a preoperative coronary angiogram revealed a very tortuous left anterior descending (LAD) artery with tandem high-grade lesions in the mid-to-distal segments. Percutaneous coronary intervention (PCI) was performed using an ultra-soft Suoh 03 guidewire to minimize the anticipated risk of the concertina effect and reduce the likelihood of guidewire-induced dissection. The lesions were successfully pre-dilated and treated with drug-eluting stents, achieving complete revascularization without complications. This case highlights the strategic use of the Suoh 03 wire in navigating tortuous coronary anatomy and safely performing PCI in such challenging vascular conditions.