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[The spiral of evil: iatrogenic coronary and aortic dissection]

Paolo Canova1, Giuseppe Musumeci2, Roberta Rossini1

  • 1Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo.

Giornale Italiano Di Cardiologia (2006)
|May 12, 2017
PubMed

Insights

Iatrogenic dissection during percutaneous coronary intervention can be treated with covered stents. This case highlights successful treatment of dissection and stent thrombosis in a myocardial infarction patient.

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Percutaneous coronary intervention (PCI) carries risks, including iatrogenic coronary and aortic dissection.
  • Iatrogenic dissections are severe complications that require effective management strategies.
  • Covered stents offer a potential solution for sealing dissections but carry a risk of thrombosis.

Observation:

  • A 60-year-old male presented with acute ST-elevation myocardial infarction.
  • The patient developed both iatrogenic coronary and aortic dissection during PCI.
  • Multiple stent thrombosis occurred as a complication.

Findings:

  • The iatrogenic dissection and subsequent stent thrombosis were successfully managed percutaneously.
  • A covered stent was deployed to seal the entry tear of the false lumen.
  • This intervention resolved the acute dissection and stabilized the patient's condition.

Implications:

  • Covered stents are a viable option for managing complex iatrogenic dissections during PCI.
  • Despite thrombogenic potential, covered stents can be effective in critical situations.
  • Further research into optimizing covered stent use and mitigating thrombosis risk is warranted.

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