Left main crumpling during left anterior descending angioplasty: hitherto unreported location for the "accordion effect".

Vessel wall shortening and deformity due to "arterial telescoping" is a not infrequent reversible phenomenon that occurs during coronary angioplasty and is associated with the advancement of a stiff wire through elongated and tortuous segments, with straightening of the artery and deep guiding catheter introduction beyond the coronary ostium. We present the first described case of the accordion effect involving the left main coronary artery. On detecting arterial crumpling, it is essential to make a differential diagnosis between the accordion syndrome and PTCA potential complications (spasm, thrombosis and dissection), to avoid further therapeutic intervention.