Delayed percutaneous coronary intervention for an extensive iatrogenic left main coronary artery dissection: a case report

J Med Case Rep. 2022 Dec 5;16(1):469. doi: 10.1186/s13256-022-03677-0.

Abstract

Background: Iatrogenic left main coronary artery dissection is a rare but serious complication that can occur both during diagnostic coronary angiography and percutaneous coronary intervention. Early diagnosis and choice of optimal management are of crucial importance for patient's outcome while representing a challenge for clinicians.

Case presentation: We present a case of iatrogenic left main coronary artery dissection occurring during diagnostic coronary angiography in a 53-year-old Greek woman with a history of coronary artery bypass grafting. Although dissection was greatly extending to mid left anterior descending artery, delayed percutaneous coronary intervention was successfully performed by carefully wiring the true lumen.

Conclusions: Delayed percutaneous coronary intervention, performed 25 days following the index event, proved to be a feasible and effective strategy for treating a widely extended left main coronary artery iatrogenic dissection.

Keywords: Case report; Coronary angiography; Iatrogenic dissection; Left main coronary artery dissection; Percutaneous coronary intervention.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Vessels* / diagnostic imaging
  • Coronary Vessels* / surgery
  • Dissection
  • Female
  • Humans
  • Middle Aged
  • Percutaneous Coronary Intervention* / adverse effects