• Images in cardiology

Catheter induced vasospasm of small calibre arteries, such as coronary, radial, or brachial arteries, is frequently observed during cardiac catheterisation, but the phenomenon in large calibre arteries has rarely been reported. We report a case in which the right iliac artery had multiple spasms during percutaneous coronary intervention (PCI) via the right femoral approach in a patient who presented with acute myocardial infarction. He was found to have acute ST segment elevation myocardial infarction. A coronary angiogram revealed a total thrombotic occlusion in the mid left anterior descending coronary artery (LAD). Primary PCI for the LAD lesion was performed with the aid of abciximab. An abdominal aortogram after the PCI revealed multiple narrowings along the right external iliac artery, causing the artery to appear like a corkscrew (left panel). However, these narrowings completely resolved without any medication or intervention (right panel).

Detection of this pseudo-lesion helped to avoid unnecessary intervention and complications.