Dual percutaneous management of Dunning type III iatrogenic aortic dissection during percutaneous coronary intervention: a case report

Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine

Abstract Background Iatrogenic aortocoronary dissection (IACD) is an uncommon but potentially life-threatening complication of percutaneous coronary intervention (PCI). s1 Case summary We report the case of a 64-year-old male who developed IACD (Dunning type II) during PCI of right coronary artery. Initial bailout with drug-eluting stents (DSE) implantation but failed to completely exclude a retrograde tear into the aortic root. A larger covered stent (CS) was successfully deployed at the ostium halting the progression of the aortic dissection. s2 Conclusion This case highlights that for PCI-induced IACD refractory to conventional DES, a CS provides a definitive barrier to halt dissection. A prompt percutaneous bailout, reinforced by strict haemodynamic control and surgical standby, is crucial for managing this catastrophic complication. s3