Accordion Effect During Percutaneous Coronary Intervention (Pci)

Pseudo lesions appear in a coronary artery during intervention due to guide wire manipulation are referred as “accordion phenomenon” and are infrequent occurrences during percutaneous coronary intervention of tortuous coronary arteries.  Occurrence of pseudo lesion or accordion phenomena puts a diagnostic challenge to the interventionist and might leads to unnecessary intervention.  The differential diagnosis includes coronary dissection, thrombus and its spasm.  Ischemia & hemodynamic compromise are possible complications. The common method to overcome this situation is pulling the guide wire out of the affected segments and leaving aside only the floppy segment.  Pseudo lesion at times response to intracoronary nitro-glycerine however, sometimes they are refractory.  We hereby report a case of Accordion phenomenon during PCI of right coronary artery & technical challenges it imposed on.