{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:55:02Z","timestamp":1781826902897,"version":"3.54.5"},"reference-count":3,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Intravascular lithotripsy (IVL) is an effective modality for modifying severely calcified coronary lesions; however, IVL-induced coronary dissection may occasionally lead to inadvertent guidewire migration into the subintimal space. In such complex scenarios, real-time intravascular ultrasound (IVUS) is essential for identifying wire position, understanding dynamic wire\u2013vessel interactions, and guiding safe stent deployment.<\/jats:p>\n <\/jats:sec>\n \n Case summary<\/jats:title>\n An 80-year-old woman with unstable angina underwent percutaneous coronary intervention for a severely calcified and tortuous left anterior descending artery. Intravascular lithotripsy was performed for calcium modification, but a longitudinal medial dissection flap developed, and the guidewire migrated into the subintimal space due to tortuosity-related wire bias. Multiple rewiring attempts using a double-lumen catheter and balloon support were unsuccessful. Real-time IVUS was used to evaluate the behaviour of a semi-compliant balloon positioned on the subintimal wire. Intravascular ultrasound demonstrated that balloon inflation redirected both the balloon and wire from the subintimal space into the true lumen, facilitated by anchoring of proximal and distal wire segments that remained within the true lumen. This confirmation enabled safe and accurate deployment of a drug-eluting stent in the true lumen.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Even when a guidewire migrates into the subintimal space during IVL-induced coronary dissection, balloon inflation may dynamically shift the device towards the true lumen due to anchoring by wire segments located proximally and distally within unaffected vessel segments. Real-time IVUS is indispensable for visualizing this dynamic behaviour and confirming whether balloon or stent expansion occurs within the true lumen. This IVUS-guided strategy may be valuable when conventional rewiring techniques fail.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag433","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T11:43:52Z","timestamp":1780746232000},"source":"Crossref","is-referenced-by-count":0,"title":["True lumen stenting guided by intravascular ultrasound-confirmed wire repositioning from the subintimal space following balloon inflation during intravascular lithotripsy-induced coronary dissection: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2601-0392","authenticated-orcid":false,"given":"Hideo","family":"Tokuyama","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kawaguchi Cardiovascular and Respiratory Hospital , 1-1-51 Maekawa, Kawaguchi City, Saitama 333-0842 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026061819472948300_ytag433-B1","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/eurheartj\/ehz850","article-title":"Vascular responses to coronary calcification following implantation of newer-generation drug-eluting stents in humans: impact on healing","volume":"41","author":"Torii","year":"2020","journal-title":"Eur Heart J"},{"key":"2026061819472948300_ytag433-B2","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1016\/j.jcin.2021.04.015","article-title":"Intravascular lithotripsy for treatment of calcified coronary lesions: patient-level pooled analysis of the Disrupt CAD studies","volume":"14","author":"Kereiakes","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2026061819472948300_ytag433-B3","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jacc.2024.12.009","article-title":"Management of coronary stent underexpansion","volume":"85","author":"Ng","year":"2025","journal-title":"J Am Coll Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag433\/68492510\/ytag433.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/6\/ytag433\/68492510\/ytag433.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/6\/ytag433\/68492510\/ytag433.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T23:47:40Z","timestamp":1781826460000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag433\/8704216"}},"subtitle":[],"editor":[{"given":"Dzan","family":"Horozic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Alexandru","family":"Patrascu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Chijioke Horatio","family":"Mosanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":3,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag433","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,6,1]]},"article-number":"ytag433"}}