Aortic Dissection Caused by Percutaneous Coronary Intervention: 2 New Case Reports and Detailed Analysis of 86 Previous Cases

Tex Heart Inst J. 2016 Feb 1;43(1):52-60. doi: 10.14503/THIJ-14-4585. eCollection 2016 Feb.

Abstract

Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We conclude that most patients can be treated conservatively or by means of stenting alone, with no need for surgical intervention.

Keywords: Angioplasty, balloon, coronary/adverse effects; aneurysm, dissecting/diagnosis/etiology/radiography/surgery/therapy; aorta/injuries; cardiac catheterization/adverse effects/methods; coronary disease/therapy; coronary vessels/injuries; iatrogenic disease; intraoperative complications/etiology; stents; treatment failure/outcome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / etiology*
  • Aortic Aneurysm, Thoracic / surgery
  • Aortic Dissection / diagnosis
  • Aortic Dissection / etiology*
  • Aortic Dissection / surgery
  • Coronary Angiography
  • Echocardiography, Transesophageal
  • Humans
  • Iatrogenic Disease
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects*
  • Reoperation
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / surgery*
  • Vascular Surgical Procedures / methods*