Novel Use of Dual-Lumen Microcatheter for False Lumen Hematoma Decompression: Tools for Consideration.

BACKGROUND

Management of iatrogenic coronary dissection is essential for all interventional cardiologists considering its incidence and high associated mortality.

CASE SUMMARY: A 66-year-old woman undergoing elective left and right heart catheterization for investigation of shortness of breath experienced iatrogenic catheter-induced ostial right coronary artery dissection. Use of intravascular ultrasound and repurposing a dual-lumen microcatheter enabled successful wiring of true lumen and percutaneous management.

DISCUSSION: Novel use and repurposing of available coronary equipment in the form of a dual-lumen microcatheter provided additional tools for management of this dangerous complication.

TAKE-HOME MESSAGES: Coronary dissection regardless of mechanism can be fatal and difficult to manage given size differences of the true and false lumen. Use of a dual-lumen microcatheter placed into the false dissection lumen with negative pressure applied can decompress the hematoma and enable wiring of the true lumen for percutaneous management.