Key result
Retrograde PCI successfully manages iatrogenic type D RCA dissection without visible collaterals.
Why the study?
Iatrogenic coronary artery dissection is a rare but serious PCI complication with limited data on managing acute vessel closure, especially without visible collateral channels.
Can retrograde PCI be used to manage iatrogenic coronary artery dissection in the absence of visible collateral channels?
Case Report (n=1)
Can retrograde PCI be used to manage iatrogenic coronary artery dissection in the absence of visible collateral channels?
Retrograde bailout stenting is a viable option for managing iatrogenic coronary artery dissection when antegrade approaches fail, even in the absence of visible collateral branches.
May support retrograde bailout in iatrogenic coronary dissection without collaterals; leaves open generalizability beyond this case.
BACKGROUND: Iatrogenic coronary artery dissection (ICAD) is an uncommon and serious complication of percutaneous coronary intervention (PCI), occurring in <1% of cases, potentially leading to abrupt vessel closure, myocardial infarction, or death. CASE SUMMARY: We describe a case of ICAD managed successfully using retrograde PCI without visible collateral channels. The patient had an iatrogenic type D dissection of the right coronary artery, treated effectively with this innovative approach. DISCUSSION: Retrograde PCI has been reported in cases with ICAD and visible septal collateral channels. However, this case demonstrates feasibility even in their absence, avoiding the need for surgical intervention. This case offers valuable insights into managing complex, life-threatening PCI complications and highlights the importance of procedural adaptability to ensure optimal outcomes. TAKE-HOME MESSAGES: Gentle contrast injection and meticulous coronary wiring minimize ICAD risk. When it occurs, retrograde bailout stenting is a viable option if antegrade approaches fail, in the absence of visible collateral branches.
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Al-Omary et al. (2025) conducted a case report in Iatrogenic coronary artery dissection (ICAD) (n=1). Retrograde percutaneous coronary intervention (PCI) was evaluated. Retrograde percutaneous coronary intervention successfully managed an iatrogenic type D dissection of the right coronary artery in the absence of visible collateral channels.
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