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Spontaneous Resolution of Catheter-Induced Iatrogenic Vein Graft Dissection: First Case Report and Review of

Prakash Suryanarayana1, Shubha Kollampare2, Mohammad Reza Movahed3

  • 1Division of Cardiology, Department of Medicine, University of Arizona School of Medicine, Tucson, Arizona.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|December 30, 2016
PubMed

Insights

This case report details a rare instance of spontaneous recovery following iatrogenic saphenous vein graft dissection after coronary angiography. The patient

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
  • Saphenous vein grafts (SVGs) are frequently used but prone to stenosis and complications.
  • Iatrogenic injury during interventions can lead to graft complications.

Observation:

  • An 86-year-old female with prior CABG presented with dyspnea and chest pain.
  • Coronary angiography revealed severe stenosis in an SVG supplying the right coronary artery.
  • Guide catheter manipulation during attempted percutaneous intervention caused SVG dissection with thrombus formation.

Findings:

  • Despite the iatrogenic injury, distal blood flow remained normal.
  • The intervention was aborted due to stable hemodynamics and risk of further dissection.
  • Follow-up angiography after 1 month demonstrated a healed dissection and patent SVG.

Implications:

  • This is the first reported case of spontaneous resolution of iatrogenic SVG dissection.
  • It highlights the potential for conservative management in select cases of SVG injury.
  • Further research into the natural history and management of iatrogenic SVG complications is warranted.

Keywords:
angiographycardiac catheterizationcoronary interventiondissectionsaphenous vein graft

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