Threading the Eye of the Needle: A Challenging Case of Iatrogenic Spiral Coronary Artery Dissection

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Coronary angiography is a common diagnostic procedure.
• Catheter-induced coronary artery dissection is a rare but severe complication.
• Prompt diagnosis and management are critical for patient outcomes.

Observation:

• A 48-year-old female presented with normal coronary arteries on angiography.
• The patient developed an extensive catheter-induced spiral dissection.
• A large false lumen significantly hindered wiring into the true lumen.

Findings:

• The case highlights the challenges in managing complex coronary dissections.
• Intravascular ultrasound (IVUS) provided critical real-time imaging.
• Successful navigation and management strategies were employed.

Implications:

• This case underscores the importance of recognizing and managing catheter-induced dissections.
• IVUS imaging is invaluable for complex interventional procedures.
• Effective management strategies can improve outcomes in rare but serious complications.