Percutaneous treatment of catheter-induced dissection of the right coronary artery and adjacent aortic wall

Abstract

Acute aortic dissection during coronary arteriography is quite rare, but is a catastrophic and life-threatening complication. Patients in this clinical setting may have a potential risk for acute myocardial infarction requiring emergency life-saving surgery. Awareness of the problem and its prompt recognition are essential. We describe a case in which a right coronary artery (RCA) dissection occurred during diagnostic coronary arteriography and extended beyond the coronary ostium into the ascending aorta. Extension to the ascending aorta occurred during injections done for positioning of stents in the proximal RCA. Sealing of the aortic dissection and rescue of the RCA with stabilization of the patient was possible with rapid stenting of its ostium.