Mechanical right coronary artery shortening and vessel wall invagination: a fourth cause of iatrogenic coronary obstruction during coronary angioplasty. A case report and review of the literature.

Coronary spasm, dissection, and localized thrombosis are recognized sources of iatrogenic obstruction during coronary angioplasty. A fourth important cause is reported, namely, guidewire-induced mechanical straightening and shortening of tortuous right coronary artery resulting in the invagination of redundant vascular tissue. Reversal is achieved with guidewire retraction. Recognition of this entity is crucial to avoid unnecessary and potentially harmful intervention.