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Catheter-induced Left Main Dissection: A Minefield in Interventional Cardiology

Varsha Rakshitha Prakash1, M A Sujith2, Sathyanarayana Rao Prakash2

  • 1Assistant Professor, Department of Cardiology, Ramaiah Medical College, Bengaluru, Karnataka, India, Corresponding Author.

The Journal of the Association of Physicians of India
|March 12, 2026
PubMed

Insights

A rare complication of coronary angiography, iatrogenic left main coronary artery dissection, proved fatal in an 89-year-old patient with acute coronary syndrome. Management strategies for this serious event were reviewed.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary angiography is essential for assessing coronary anatomy.
  • Iatrogenic coronary artery dissection is a rare but severe complication of coronary catheterization.
  • Acute coronary syndrome necessitates timely diagnostic and therapeutic interventions.

Purpose of the Study:

  • To report a fatal case of iatrogenic left main coronary artery dissection during coronary angiography.
  • To discuss attempted interventions for managing this complication.
  • To review current approaches to iatrogenic left main dissections.

Main Methods:

  • Case report of an 89-year-old male with Non-ST-segment elevation myocardial infarction.
  • Coronary angiography procedure.
  • Review of literature on iatrogenic left main coronary artery dissections.

Main Results:

  • The patient experienced a fatal left main coronary artery dissection during the procedure.
  • Interventions were attempted to manage the dissection.
  • The case highlights the risks associated with invasive coronary procedures.

Conclusions:

  • Iatrogenic left main coronary artery dissection is a life-threatening complication.
  • Prompt recognition and appropriate management are crucial.
  • Further research into preventative and therapeutic strategies is warranted.

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