Treatment of iatrogenic aortic dissection by percutaneous stent placement

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• Cardiac catheterization via the right femoral artery is a common procedure.
• Complications, though rare, can arise during guidewire manipulation.
• Aortic dissection is a serious, albeit infrequent, complication of angiography.

Observation:

• Difficulty advancing a guidewire beyond the aortic arch during elective cardiac catheterization.
• Subsequent development of back pain and hypotension in the patient.
• Computed tomography confirmed aortic dissection from the external iliac artery to the aortic arch.

Findings:

• The entry site in the external iliac artery was identified as the source filling the thoraco-abdominal aortic dissection.
• Percutaneous stenting of the external iliac artery entry point successfully occluded the dissection.
• This represents the first reported case of managing angiography-induced aortic dissection with endovascular stenting.

Implications:

• Percutaneous stenting offers a minimally invasive treatment option for specific cases of iatrogenic aortic dissection.
• Understanding guidewire mechanics and potential entry points is crucial for preventing vascular complications.
• This case highlights the importance of prompt diagnosis and tailored endovascular intervention for rare arterial injuries.