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Aortocoronary dissection resolved by coronary stenting guided by intracoronary ultrasound
Hirotaka Oda1, Katsuzi Hatada, Katsuyuki Sakai
1The Department of Cardiology, Niigata City General Hospital, Japan. oda@hosp.niigata.niigata.jp
Insights
A 70-year-old man experienced aortocoronary dissection during percutaneous coronary intervention (PCI) for a blocked right coronary artery. Intracoronary ultrasound (ICUS) guided successful stenting, demonstrating ICUS
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Medical imaging
Background:
- A 70-year-old male presented with unstable angina due to chronic total occlusion (CTO) of the proximal right coronary artery.
- Percutaneous coronary intervention (PCI) was chosen as the treatment strategy.
Observation:
- Forceful guide catheter manipulation during PCI resulted in an aortocoronary dissection.
- The dissection involved the right Valsalva sinus and the ascending aorta.
Findings:
- Intracoronary ultrasound (ICUS) provided detailed visualization of the aortocoronary dissection.
- ICUS guidance was crucial for the successful execution of coronary stenting.
Implications:
- This case highlights the utility of ICUS in managing complex PCI complications.
- ICUS can aid in accurate diagnosis and successful treatment of iatrogenic aortocoronary dissections.
- Adherence to careful guide catheter manipulation is essential during PCI procedures.
Abstract:
Percutaneous coronary intervention (PCI) was performed for chronic total occlusion of the proximal right coronary artery in a 70-year-old male with unstable angina. The forceful manipulation of the guide catheter led to an aortocoronary dissection involving the right Valsalva sinus and the ascending aorta. Intracoronary ultrasound (ICUS) showed the important characteristics of the dissection, enabling successful coronary stenting under ICUS guidance.