Non-surgical management of iatrogenic aortic dissection (Dunning class 3) caused by percutaneous coronary intervention

Gryko, Adam B.; Chlabicz, Małgorzata; Jakim, Piotr; Nowak, Konrad; Bachórzewska−Gajewska, Hanna; Dobrzycki, Sławomir

doi:10.5114/aic.2021.110928

pwki

2021

DOI: 10.5114/aic.2021.110928

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Non-surgical management of iatrogenic aortic dissection (Dunning class 3) caused by percutaneous coronary intervention

Adam B. Gryko¹,

Małgorzata Chlabicz²,

Piotr Jakim³

et al.

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Cited by 4 publications

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“…Acute aortic dissection should also be distinguished from iatrogenic aortic dissection associated with coronary angiography. Iatrogenic aortic dissections are statistically significantly more common in myocardial infarction and affect the right coronary artery [ 2 ].…”

mentioning

confidence: 99%

Is ST-segment elevation myocardial infarction always a simple diagnosis?

Zalas,

Kuliczkowski,

Pachana

et al. 2023

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mentioning

confidence: 99%

Is ST-segment elevation myocardial infarction always a simple diagnosis?

Zalas,

Kuliczkowski,

Pachana

et al. 2023

pwki

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“…In our case neither of these features were present, supporting deferred PCI. Recent studies indicate the possibility of stenting as iatrogenic aortic dissection’s treatment [ 3 ]. In our case the conservative approach was chosen due to the asymptomatic course and favourable type of IMH.…”

mentioning

confidence: 99%

Deferment of revascularization in ST-elevation myocardial infarction with coexisting aortic intramural hematoma

Błaziak,

Urban,

Wietrzyk

et al. 2023

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Acute Aortic Dissection Complicating Emergency Coronary Intervention for Hyperacute Stent Thrombosis

Nadeem,

Sanjana,

Abdalla

et al. 2024

Dubai Med J

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Introduction: Iatrogenic acute aortic dissection resulting from coronary interventions can have fatal consequences. Although it is an uncommon complication during percutaneous coronary interventions (PCI), it can arise from various factors. Our case report aims to address this rare presentation further, seeking to enhance preprocedural planning which can result in better outcomes. Case Report: We describe an intriguing case of an elderly female patient with multiple cardiovascular risk factors who came to our emergency department presenting with chest pain. Her Electrocardiogram revealed an inferior ST-elevation myocardial infarction (STEMI) for which she underwent successful primary PCI of the right coronary artery (RCA). Four days later, she had an infero-posterior STEMI, which necessitated immediate coronary angiography. Angiography revealed thrombosis of the stent placed earlier in the RCA. On attempting recanalization of the vessel, an acute aortic dissection was identified and was successfully managed by ostial stenting. Follow-up imaging showed no residual dissection, and the patient was found to be comfortable and stable post-procedure. Conclusion: We recommend optimizing blood pressure and performing rapid ostial stenting in these cases, irrespective of the dissection’s origin. This will facilitate effective sealing of the entry site and prevent further progression of the dissection. Our report highlights the favorable results achieved with immediate ostial stenting while discussing the conservative approach to managing such cases.

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Non-surgical management of iatrogenic aortic dissection (Dunning class 3) caused by percutaneous coronary intervention

Cited by 4 publications

References 1 publication

Is ST-segment elevation myocardial infarction always a simple diagnosis?

Is ST-segment elevation myocardial infarction always a simple diagnosis?

Deferment of revascularization in ST-elevation myocardial infarction with coexisting aortic intramural hematoma

Acute Aortic Dissection Complicating Emergency Coronary Intervention for Hyperacute Stent Thrombosis

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