Related Experiment Video

Updated: Jun 19, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Iatrogenic right coronary artery dissection distal to a total occlusion: a case report

Demetrios Antoniades1, Stavros Apostolakis, Spiros Tzoras

  • 1Department of Cardiology, Army Veterans Hospital Athens Greece. cardiologiki@nimts.gr

Cases Journal
|October 16, 2009
PubMed

Insights

Coronary angiography can rarely cause spontaneous coronary artery dissection (SCAD) due to contrast injection, even without mechanical trauma. This case highlights the unpredictable nature of atherosclerotic vessels.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Radiology

Background:

  • Coronary artery dissection is a rare but serious complication of coronary angiography.
  • It carries a significant risk of morbidity and mortality.
  • Spontaneous coronary artery dissection (SCAD) can occur without direct mechanical manipulation.

Observation:

  • A case of right coronary artery dissection distal to a total occlusion is presented.
  • Dissection occurred during contrast injection, not due to catheter or guidewire manipulation.
  • The dissection had no immediate clinical consequences for the patient.

Findings:

  • Contrast injection into the proximal right coronary artery may increase shear stress.
  • This increased stress, transmitted through anastomotic branches, can lead to dissection of diseased distal endothelium.
  • This represents a previously undescribed mechanism for contrast-induced SCAD.

Implications:

  • Atherosclerotic coronary artery tissue is inherently unpredictable.
  • Extreme caution is warranted during contrast injections in patients with coronary artery disease.
  • This phenomenon underscores the importance of careful technique in coronary angiography.
Abstract

More Related Videos

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)

Published on: April 24, 2017

Related Concept Videos

Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...