B-15 | Incidence, Treatment and Outcomes of Coronary Artery Dissection During Percutaneous Coronary Intervention

Coronary artery dissection is a feared and potentially life-threatening complication of percutaneous coronary intervention (PCI). We examined the clinical, angiographic, procedural characteristics, outcomes at tertiary care institution. Between 2014 2019, unplanned occurred in 141 10,278 PCIs (1.4%). Patient age was 68 (60, 78) years, 68% were men, 83% had hypertension. The prevalence diabetes (29%) prior PCI (37%) high. Most target vessels significantly diseased: 48% moderate/severe tortuosity 62% calcification. most common cause dissection, shown Figure 1A, guidewire advancement (30%), followed by stenting (23%) balloon angioplasty (18%). TIMI flow 0 33% 1-2 41% cases. Intravascular imaging used 17% Stenting to treat 73% patients, 1B. There no consequence 43% patients. Technical success 65% 55%, respectively. In-hospital major adverse cardiovascular events 23% patients: 13 (9%) an acute myocardial infarction (MI), 3 (2%) emergency bypass graft surgery, 10 (7%) died. During mean follow up 1,612 days, 26 (20%) patients died, rate lesion revascularization 8.3% (n=11). infrequent PCI, but associated with severe events, such as death MI.