Iatrogenic Aortocoronary Dissection

Iatrogenic aortocoronary dissection (IACD) is a rare but potentially life-threatening complication of percutaneous coronary intervention or diagnostic angiography. The increasing complexity of interventions, especially cases involving chronic total occlusions, calcified lesions, and aggressive balloon dilation, has heightened the risk of IACD. It is often underreported, with an estimated incidence of 0.02% to 0.10%. We present 4 patients with IACD who were managed at our institute in 2024. The right coronary artery was the most frequently involved vessel, and type III IACD was the most common variant. Management strategies included stenting for 50% of patients and conservative management for 50%; no patient required surgical intervention. All patients remained stable and were doing well at follow-up. Our case series provides valuable insights into the risk factors, clinical presentation, and management of IACD, highlighting the importance of prevention, early recognition, and tailored treatment strategies to optimize patient outcomes.