Guiding Catheter-Induced Dissection of the Left Main Coronary Artery: Percutaneous Coronary Intervention or Surgery?

[摘要] Background: Catheter-induced left main coronary artery (LMCA) dissection, though quite rare, is one of the most dreaded and life-threatening complication of coronary intervention and requires urgent management because if not promptly diagnosed and treated with myocardial revascularization, it can have fatal consequences. Case Report: Here, we report a case iatrogenic dissection of left main coronary artery by vigorous manipulation of extra backup (EBU) guiding catheter in a 73-year old male during revascularization of proximal left anterior descending artery which was successfully bailed out by stenting of left main artery using 4×23 mm Xience Prime everolimus eluting stent (Abott Vascular; USA) at 12 atm pressure achieving complete sealing of flap with TIMI III flow. Conclusion: Coronary artery dissection can be precipitated by catheter manipulation.

[学科分类] 生理学

[关键词] Coronary Vessels;Dissecting Aneurysm;Iatrogenic Disease;Myocardial Revascularization;Stents.