Coronary pseudo-lesions induced in the left anterior descending and right coronary artery by the angioplasty guide-wire

New lesions appearing during coronary angioplasty may be due to a number of causes including spasm, dissection, embolisation, thrombosis and creation of a pseudo-lesion. The term “coronary pseudo-lesions” has been given to describe artefactual lesions occurring during percutaneous transluminal coronary angioplasty and induced by the angioplasty guide-wire and/or balloon as a result of straightening of the vesselʹs curvature. No specific treatment is required as they resolve completely on removal of the angioplasty wire. Few modern texts of interventional cardiology contain description of this important phenomenon and we suspect that they pass largely unrecognised. All angioplasty operators should become familiar with this complication as failure to do so may lead to inappropriate intervention with attendant increase in risk to the patient. We report three cases of coronary pseudo-lesion. In two cases affecting the right coronary artery and in the third the left anterior descending coronary artery. Pseudo-lesions affecting the right coronary artery have been previously reported in the literature however pseudo-lesion affecting the left anterior descending artery has not been described. The possible mechanisms of this phenomenon and its management are discussed.