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Aortic dissection caused by angiographic procedures
I Sakamoto1, K Hayashi, N Matsunaga
1Department of Radiology, Nagasaki University School of Medicine, Japan.
Insights
Iatrogenic aortic dissection, a complication of angiographic procedures, presents in various types and locations. Computed tomography (CT) aids in diagnosis and monitoring, with retrograde dissections often resolving without surgery.
Area of Science:
- Cardiovascular Imaging
- Interventional Radiology
- Vascular Surgery
Background:
- Angiographic procedures carry a risk of iatrogenic complications.
- Aortic dissection is a serious vascular emergency.
- Understanding iatrogenic aortic dissection is crucial for patient safety.
Purpose of the Study:
- To detail the presentation, clinical course, and outcomes of aortic dissection.
- To investigate dissections specifically caused by angiographic procedures.
Main Methods:
- Retrospective review of approximately 15,500 angiographic procedures (1985-1991).
- Identification and analysis of six cases of iatrogenic aortic dissection.
- Utilized computed tomography (CT) for diagnosis and follow-up.
Main Results:
- Dissections were Stanford type A (3 patients) and type B (3 patients).
- Injury sites included abdominal aorta, brachiocephalic artery, thoracic aorta, and iliac artery.
- Retrograde dissections resolved spontaneously, while anterograde dissections persisted; all managed non-surgically.
Conclusions:
- Angiographers must recognize and anticipate iatrogenic aortic dissection.
- CT is effective for determining the extent and type of dissection.
- Non-surgical management can be successful for certain types of iatrogenic aortic dissection.
Purpose:
To describe findings in, and the clinical course and outcome of, aortic dissection (dissecting aneurysm) caused by angiographic procedures.
Materials And Methods:
The records of approximately 15,500 angiographic procedures performed between 1985 and 1991 were reviewed. In the six cases of iatrogenic aortic dissection identified, computed tomography (CT) was performed for diagnosis, follow-up, or both.
Results:
The type of aortic dissection was Stanford type A in three patients and Stanford type B in three patients. The sites of injury were the abdominal aorta (n = 2), right brachiocephalic artery (n = 2), middle of the thoracic aorta (n = 1), and right common iliac artery (n = 1). One patient had anterograde dissection from the site of injury; two patients, retrograde dissection; and three patients, extensive dissection that extended in both anterograde and retrograde directions. Retrograde dissections decreased in size or disappeared in 1-3 months due to the absence of reentry, whereas anterograde dissections persisted during follow-up (15-27 months). All patient were treated without surgery.
Conclusion:
Angiographers should be aware of this potentially serious complication. The extent and type of the aortic dissection can be determined with CT.