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

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

Romanian Journal of Cardiology
Volume 35 (2025): Issue 2 (June 2025)
By: Dan Pascut,  Ndricim Tobli and  Blerim Luani  
Open Access
|Jun 2025

Figures & Tables

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.
DOI: https://doi.org/10.2478/rjc-2025-0021 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X
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Language: English
Page range: 148 - 151
Published on: Jun 26, 2025
Published by: Romanian Society of Cardiology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
Tortuous coronary artery,
Concertina effect,
Suoh 03 guidewire,
Percutaneous coronary intervention,
Complex PCI
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Cardiology,
Surgery,
Cardiac surgery,
Pediatrics and juvenile medicine,
Paediatric cardiology

© 2025 Dan Pascut, Ndricim Tobli, Blerim Luani, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

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