When Subtle Guiding Catheter-Induced Stent Deformation Leads to Abluminal Guidewire Passage: Successful IVUS Tip-Detection-Guided Bailout.

Authors

Yuto Abe, Yuya Hirata, Fumimasa Tabata, Tomomi Koizumi

Published in

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. Sep 16, 2026. Epub Sep 16, 2026.

Abstract

Incomplete stent apposition at the proximal coronary artery may predispose to subtle guiding catheter-induced stent deformation, creating a gap between the stent and the vessel wall that facilitates inadvertent abluminal guidewire passage. We report a case in which balloon dilatation over an unrecognized abluminal guidewire resulted in severe proximal stent deformation and was successfully managed by real-time IVUS tip-detection-guided rewiring into the true stent lumen, avoiding additional stent implantation. This case highlights the importance of careful guiding catheter manipulation, meticulous intravascular imaging assessment after guidewire crossing, and IVUS-guided bailout techniques for the prevention, early recognition, and management of this potentially serious procedural complication.

PMID:
42746978
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.

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