Key result
Intravascular ultrasound-guided immediate stenting with at least a 5-mm stent margin and avoidance of antegrade contrast injections is the preferred management for catheter-induced coronary dissection.
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Highlights treatment strategies for catheter-induced coronary dissection during angiography or intervention, indicating immediate stenting as the preferred approach.
C atheter-induced dissection is an infrequent, but potentially severe complication that may occur during diagnostic coronary angiography or percutaneous coronary intervention.Whereas minor degrees of dissection are usually straightforward to treat, management of more complex dissections are often challenging.Immediate stenting is usually the preferred treatment in most cases.This includes coronary dissections with retrograde involvement of the aorta as long as the aortic dissection is not extensive (1).It is essential to have a clear algorithm for treating this complication should it occur (Figure 1).In this issue of JACC: Case Reports, Hashmani et al. (2) provide valuable insights into the
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Harding et al. (2019) conducted an editorial in Catheter-induced coronary artery dissection. Intravascular ultrasound (IVUS)-guided immediate stenting vs. Optical coherence tomography (OCT), bail-out re-entry techniques, or emergency CABG was evaluated. Intravascular ultrasound-guided immediate stenting with at least a 5-mm stent margin and avoidance of antegrade contrast injections is the preferred management for catheter-induced coronary dissection.
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