Lin Chen, Fandy Santoso Budiardjo, Xiaofang Chen, Huiyuan Kang, Ye Cheng
This case highlights that for PCI-induced IACD refractory to conventional DES, a CS provides a definitive barrier to halt dissection. A prompt percutaneous bailout, reinforced by strict haemodynamic control and surgical standby, is crucial for managing this catastrophic complication.
BACKGROUND: Iatrogenic aortocoronary dissection (IACD) is an uncommon but potentially life-threatening complication of percutaneous coronary intervention (PCI).
CASE SUMMARY: We report the case of a 64-year-old male who developed IACD (Dunning type II) during PCI of right coronary artery. Initial bailout with drug-eluting stents (DSE) implantation but failed to completely exclude a retrograde tear into the aortic root. A larger covered stent (CS) was successfully deployed at the ostium halting the progression of the aortic dissection.
CONCLUSION: This case highlights that for PCI-induced IACD refractory to conventional DES, a CS provides a definitive barrier to halt dissection. A prompt percutaneous bailout, reinforced by strict haemodynamic control and surgical standby, is crucial for managing this catastrophic complication.