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We describe a rare type of dissection after PTCA which caused a severe obstruction of the vessel segment proximal to the dilatation site without a visible dissection flap. Intravascular ultrasound was used to elucidate the morphology of the proximal vessel obstruction, which revealed an intramural hematoma extending into the proximal vessel segment as underlying mechanism. A Palmaz\u2010Schatz stent was placed at the entry site of this hematoma, which led to the relief of the proximal vessel obstruction. After 3 months of anticoagulation therapy the repeat coronary angiography showed no significant restenosis. This demonstrates the unique insight into the underlying morphology of failed PTCA by intravascular ultrasound, which can help to manage even rare and unusual complications. \u00a9 1995 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ccd.1810360219","type":"journal-article","created":{"date-parts":[[2007,3,2]],"date-time":"2007-03-02T07:03:11Z","timestamp":1172818991000},"page":"173-178","source":"Crossref","is-referenced-by-count":11,"title":["Extensive intramural hematoma as the cause of failed coronary angioplasty: Diagnosis by intravascular ultrasound and treatment by stent implantation"],"prefix":"10.1002","volume":"36","author":[{"given":"Gerald S.","family":"Werner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans R.","family":"Figulla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Grosse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinrich","family":"Kreuzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,10,26]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"9","article-title":"Coronary artery angiographic changes after percutaneous transluminal coronary angioplasty: manual of operations NHLBI","volume":"6","year":"1985","journal-title":"PTCA Registry"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(07)80008-1"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90600-H"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90211-T"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90780-O"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90779-H"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.3.913"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90197-U"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90252-I"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.1.64"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90827-N"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90341-W"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.3.812"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.3.916"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90893-4"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90865-I"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)91037-I"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90774-U"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90171-I"},{"key":"e_1_2_1_21_2","first-page":"1","article-title":"Intravascular criteria for successful stent deployment (Abstract)","volume":"88","author":"Nakamura S","year":"1993","journal-title":"Circulation"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.3109\/14017439309099087"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/1010-7940(89)90117-6"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90455-8"},{"key":"e_1_2_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90163-C"}],"container-title":["Catheterization and Cardiovascular Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.1810360219","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.1810360219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T16:11:49Z","timestamp":1698250309000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.1810360219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,10]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1995,10]]}},"alternative-id":["10.1002\/ccd.1810360219"],"URL":"https:\/\/doi.org\/10.1002\/ccd.1810360219","archive":["Portico"],"relation":{},"ISSN":["0098-6569","1097-0304"],"issn-type":[{"value":"0098-6569","type":"print"},{"value":"1097-0304","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,10]]}}}