Aortic dissection caused by angiographic procedures.
OBJECTIVE
To describe findings in, and the clinical course and outcome of, aortic dissection (dissecting aneurysm) caused by angiographic procedures.


METHODS
The records of approximately 15,500 angiographic procedures performed between 1985 and 1991 were reviewed. In the six cases of iatrogenic aortic dissection identified, computed tomography (CT) was performed for diagnosis, follow-up, or both.


RESULTS
The type of aortic dissection was Stanford type A in three patients and Stanford type B in three patients. The sites of injury were the abdominal aorta (n = 2), right brachiocephalic artery (n = 2), middle of the thoracic aorta (n = 1), and right common iliac artery (n = 1). One patient had anterograde dissection from the site of injury; two patients, retrograde dissection; and three patients, extensive dissection that extended in both anterograde and retrograde directions. Retrograde dissections decreased in size or disappeared in 1-3 months due to the absence of reentry, whereas anterograde dissections persisted during follow-up (15-27 months). All patient were treated without surgery.


CONCLUSIONS
Angiographers should be aware of this potentially serious complication. The extent and type of the aortic dissection can be determined with CT.
Sakamoto
I
I
Department of Radiology, Nagasaki University School of Medicine, Japan.
Hayashi
K
K
Matsunaga
N
N
Matsuoka
Y
Y
Uetani
M
M
Fukuda
T
T
Fujisawa
H
H
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology*; D000792:Angiography / Q000009:adverse effects*; D001012:Aorta, Abdominal / Q000293:injuries; D001013:Aorta, Thoracic / Q000293:injuries; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000209:etiology*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D014057:Tomography, X-Ray Computed