title: A case of an occlusive right coronary artery dissection after stent implantation: dilemmas and challenges.
abstract: A 53-year-old man with stable angina had a staged percutaneous coronary intervention to a critical focal stenosis of the mid-segment of the right coronary artery (RCA). Two hours after successful RCA stent implantation, the patient re-presented with inferior ST elevation secondary to acute dissection originating at the distal edge of the stent, causing subtotal occlusion of the distal RCA. The patient had TIMI-2 flow in the posterolateral branch and occlusion of the posterior descending artery. This case describes the procedural challenges the operators were faced with and successful use of the "rescue STAR" technique as a last resort.
authors.affiliation: Imperial College London, National Heart and Lung Institute, Sir Alexander Fleming Building, South Kensington Campus, SW7 2AZ, London, UK. v.panoulas@imperial.ac.uk  
authors.forename: Vasileios F
authors.initials: VF
authors.lastname: Panoulas
authors.forename: Filippo
authors.initials: F
authors.lastname: Figini
authors.forename: Gennaro
authors.initials: G
authors.lastname: Giustino
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004562:Electrocardiography / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011475:Prosthesis Failure / Q000009:adverse effects*; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome