Catheter-induced bilateral coronary ostium dissection in a patient with long-term steroid therapy

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Medicine

Background:

• Coronary artery dissection is a rare but serious complication during cardiac procedures.
• Diagnostic coronary angiography carries inherent risks, including iatrogenic arterial injury.
• Long-term steroid therapy is associated with potential vascular complications.

Observation:

• A 44-year-old male presented with angina symptoms.
• The patient developed catheter-induced bilateral coronary artery dissection during diagnostic coronary angiography.
• The patient had a history of nephrotic syndrome treated with long-term steroids.

Findings:

• Successful stenting of the left main trunk, left anterior descending artery, and right coronary ostium achieved procedural success.
• The bilateral nature of the dissection in this case is noteworthy.
• The potential role of long-term steroid therapy in the pathogenesis of coronary dissection warrants further investigation.

Implications:

• This case underscores the importance of recognizing and managing catheter-induced coronary dissections.
• Successful stenting provides a viable treatment option for complex coronary dissections.
• Further research is needed to elucidate the link between long-term corticosteroid use and coronary artery dissection risk.