title: Retrograde dissection during percutaneous coronary intervention: sealing of the entry site by covered stent implantation.
abstract: We present a case of iatrogenic aortic haematoma, developed during percutaneous coronary intervention, treated with covered stent implantation followed by a conservative approach characterised by the integration of both clinical and multimodal imaging information. This complication can lead to overt aortic dissection (28-47%), rupture (20-45%) or death (21%). In 10% of the cases it can completely regress. Guidelines for its treatment are debated because of the unpredictable natural history of intramural haematoma. Nowadays, a close follow-up with multimodal imaging is considered a valid strategy for the appropriate management of this severe condition. On the basis of the patient's clinical condition and the information obtained by multiple imaging tests (angiography, transthoracic and transesophageal echocardiography and multidetector CT scan) we decided to treat our patient with medical therapy. To date, a 1-year follow-up negative for cardiac events is recorded.
authors.affiliation: Department of Cardiology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Gian Battista
authors.initials: GB
authors.lastname: Danzi
authors.forename: Alfonso
authors.initials: A
authors.lastname: Campanile
authors.forename: Fabiola B
authors.initials: FB
authors.lastname: Sozzi
authors.forename: Carla
authors.initials: C
authors.lastname: Bonanomi
mesh_terms: D000368:Aged; D001011:Aorta / Q000293:injuries*; D023921:Coronary Stenosis / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D011859:Radiography; D015607:Stents / Q000009:adverse effects*