Intravascular ultrasound system guided bail-out stent implantation for iatrogenic aortocoronary dissection: A case report

Abstract Background Iatrogenic aortocoronary dissection (ACD) is a rare but potentially devastating complication of cardiac catheterisation. We describe case an iatrogenic ACD following catheter engagement and balloon inflation the proximal right coronary artery (RCA) during elective percutaneous intervention (PCI). Case summary An 81-year-old woman presented with acute inferior wall ST-elevation myocardial infarction. Emergent angiography revealed three-vessel diseases. Primary PCI for culprit lesion occluded mid-circumflex was successfully performed. After 10 days, residual RCA lesions RCA, detected. Intravascular ultrasound-guided stent implantation sealing entry tear prevented further dissection. The postoperative course uneventful, patient discharged 1 week later. Follow-up computed tomography disappearance intramural haematoma. Discussion This emphasises importance prompt detection ACD. Heart team discussion essential to determine whether cardiovascular surgery or management should be Bail-out frequently used effective, intravascular ultrasound system would help recognise morphology ACD, contributing safe procedure.