Iatrogenic right coronary artery dissection distal to a total occlusion: a case reportReportar como inadecuado

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Cases Journal

, 2:6797

First Online: 02 July 2009Received: 23 March 2009Accepted: 25 May 2009DOI: 10.4076-1757-1626-2-6797

Cite this article as: Antoniades, D., Apostolakis, S., Tzoras, S. et al. Cases Journal 2009 2: 6797. doi:10.4076-1757-1626-2-6797


IntroductionCoronary artery dissections with or without rupture is a rare but well-recognized complication of coronary angiography with a high morbidity and mortality rate.

Case presentationWe present a rare case of right coronary artery dissection distal to a totally occluded vessel. The vessel dissected during the second injection of contrast agent without any direct mechanical manipulation catheter or guide-wire induced. Hopefully the dissection had no clinical consequences and the patient was discharged after 48 hour intensive monitoring.

ConclusionsWe believe that the contrast agent that was forced in the proximal part of the RCA increased through the anastomotic branches the sheer stress on the diseased endothelium of the distal artery causing it to dissect. It is an instructive -not previously described- phenomenon that underscores that atherosclerotic tissue is unpredictable and should be treated with extreme caution.

AbbreviationsACEangiotensin-converting enzyme

CAcoronary angiography

CABGcoronary artery bypass graft

HDLhigh density lipoprotein

ICADiatrogenic coronary artery dissection

LADleft anterior descending

RCAright coronary artery

SPECTsingle photon emission computed tomography.

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Autor: Demetrios Antoniades - Stavros Apostolakis - Spiros Tzoras - Kyriakos Lazaridis

Fuente: https://link.springer.com/

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