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Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
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Iatrogenic Aortic Root Injury from Coronary Interventions: Early and Follow-up CT Imaging Findings

Luca A Cappellini1, Matthias Eberhard1, Christian Templin1

  • 1Institute of Diagnostic and Interventional Radiology (L.A.C., M.E., R.M.), Department of Cardiology, University Heart Center (C.T., R.M.), and Department of Cardiac Surgery (P.R.V.), University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland; and Department of Radiology, Cardiovascular Imaging Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy (L.A.C., H.A.).

Radiology. Cardiothoracic Imaging
|December 22, 2021
PubMed

Insights

Aortic injury after invasive coronary angiography is rare. CT scans revealed subintimal contrast media staining in the aortic root, which resolved favorably in most patients, indicating a good short-term outcome.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Radiology

Background:

  • Aortic injury is a rare but serious complication of invasive coronary angiography.
  • Prompt diagnosis and understanding of outcomes are crucial for patient management.

Purpose of the Study:

  • To evaluate the imaging findings and short-term outcomes of aortic injury following invasive coronary angiography.
  • To characterize the presentation of subintimal contrast media staining in the aortic root.

Main Methods:

  • Retrospective review of four patients experiencing aortic injury post-coronary angiography.
  • Computed Tomography (CT) and CT angiography were used for diagnosis and follow-up.
  • Analysis of contrast media (CM) distribution and communication with the aortic lumen.

Main Results:

  • Three patients presented with subintimal CM staining in the aortic root without lumen communication.
  • One patient developed classic aortic dissection with CM in the false lumen.
  • Short-term follow-up CT demonstrated resolution of CM staining in all cases.

Conclusions:

  • Iatrogenic aortic injury from invasive coronary angiography can manifest as subintimal CM staining.
  • This specific finding, without lumen communication, appears to have a favorable short-term outcome.
  • CT angiography is valuable for diagnosing and monitoring these injuries.

Keywords:
CT AngiographyFluoroscopyPercutaneous

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