Key result
PCI-induced aortic dissection carries ~7% mortality and mostly permits conservative management or stenting alone.
Case Report (n=88)
Most cases of iatrogenic aortic dissection during PCI involve the right coronary artery and can be managed conservatively or with stenting alone, avoiding the need for surgical intervention.
Supports conservative or stent management in PCI-related aortic dissection; leaves open standardized protocols pending prospective data.
Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We conclude that most patients can be treated conservatively or by means of stenting alone, with no need for surgical intervention.
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Shah et al. (2016) conducted a case report in Aortic dissection caused by percutaneous coronary intervention (n=88). Percutaneous coronary intervention was evaluated on Overall mortality rate. Aortic dissection caused by percutaneous coronary intervention had an overall mortality rate of 7.1%, and most patients can be treated conservatively or by stenting alone.
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