title: Diagnostic efficacy of coronary CT angiography as a follow-up modality for procedure-related coronary dissection.
abstract: Procedure-related coronary dissection is associated with an increased risk of major adverse cardiovascular events after percutaneous coronary intervention (PCI). In most patients with such an iatrogenic complication, further PCI or bypass surgery aimed at complete revascularization is performed. Moreover, conventional coronary angiography has been used as a standard modality in the follow-up of such patients. The present report describes a 70 year old female patient who was complicated by catheter-related extensive coronary dissection in the right coronary artery (RCA) when treated for an acute myocardial infarction. Although RCA flow was insufficient, we decided against revascularization and followed her medically without additional revascularization procedures. Her clinical course had been uneventful for 4 years. However, symptoms of effort angina developed and re-examinations were performed at approximately 5 years after the myocardial infarction. Although conventional coronary angiography failed to show the culprit lesion responsible for the angina symptoms, the superior spatial resolution of the coronary CT angiography clearly identified significant progression of the stenotic lesion in the true lumen of the dissected RCA. Thus, coronary CT angiography might be considered as a possible first-line follow-up modality in patients with procedure-related coronary dissection.
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Hasumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iwata
authors.forename: Kan
authors.initials: K
authors.lastname: Saito
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Fujiu
authors.forename: Jiro
authors.initials: J
authors.lastname: Ando
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Imai
authors.forename: Hideo
authors.initials: H
authors.lastname: Fujita
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed