Key result
Entry-site stenting and conservative therapy resolve iatrogenic type A dissection false lumen by Day 7.
Why the study?
Iatrogenic type A aortic dissection during PCI is a rare but life-threatening complication usually managed surgically, with limited data on conservative management.
Case Report (n=1)
Conservative management may be a safe alternative to surgery in selected cases of iatrogenic type A aortic dissection during PCI when the entry tear is successfully sealed.
Supports conservative management over surgery in select iatrogenic type A aortic dissection during PCI; leaves open broader adoption pending further study.
BACKGROUND: Iatrogenic type A aortic dissection (TAAD) during percutaneous coronary intervention (PCI) is a rare but life-threatening complication, usually managed surgically. CASE PRESENTATION: We report the case of a 59-year-old patient who developed an ascending aortic dissection extending to the proximal arch during left circumflex (LCX) chronic total occlusion (CTO) recanalization. Stenting of the LCX and left main coronary artery successfully sealed the entry site and stabilized the patient. Computed tomography revealed a false lumen occupying 51% of the aortic diameter, without involvement of supra-aortic branches. Conservative management was initiated with strict anti-impulse therapy and staged dual antiplatelet therapy. At 24 h, the false lumen regressed to 37%, with complete resolution by Day 7. CONCLUSION: In selected cases of iatrogenic TAAD during PCI, conservative management following successful sealing of the entry tear may represent a safe alternative to sugery.
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Mallouli et al. (2026) conducted a case report in Iatrogenic type A aortic dissection during percutaneous coronary intervention (n=1). Conservative management (strict anti-impulse therapy and staged dual antiplatelet therapy) following stenting was evaluated on Resolution of false lumen. Conservative management following successful stenting of the entry site led to complete resolution of the false lumen by Day 7 in a patient with iatrogenic type A aortic dissection during PCI.
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