IATROGENIC DISSECTION OF THE LEFT CORONARY ARTERY. CLINICAL CASE

Abstract

Iatrogenic dissection of the coronary arteries is a rare, but life-threatening complication of Interventional surgery. There are almost complete descriptions of the main causes of risk groups, clinical and angiographic characteristics of coronary arteries dissections. However, the available literature does not have significant studies clearly regulating further tactics to resolve this condition. Traditionally, the selection methods are: coronary artery bypass surgery, endovascular stenting of dissection defect of arteries and, in rare cases, conservative treatment. In this paper we present a clinical case of iatrogenic non occlusal dissection of coronary artery during planned selective coronary angiography, which developed acute occlusion of the mouth of the anterior descending artery. Stent thrombosis was diagnosed 30 minutes after balloon angioplasty with stenting front descending artery. It was followed by balloon angioplasty of the stented segment and stenting of the proximal segment of the anterior descending artery. The control selective coronary angiography diagnosed dissection of the anterior descending artery, implantation of coronary graph-stent was performed. There is a retrospective analysis of complications received and a review of the literature on this topic. The findings show that under conditions of iatrogenic dissection of coronary artery the immediate stenting seems a reasonable and feasible treatment option with acceptable delayed results. But, of course, first one should pay attention to the technical aspects and materiel of the coronary interventions that will reduce the risks of any diagnostic or interventional procedure.