title: Iatrogenic Aorto-Coronary Dissection Successfully Treated With IVUS Guided Unprotected Left Main Stenting: Case Report and Review of Literature.
abstract: A 52-year-old male underwent cardiac catheterization for abnormal stress test. Trans-radial coronary angiography revealed a severe proximal left anterior descending artery (LAD) lesion. LAD angioplasty was performed with two drug-eluting stents. This resulted in dissection of the proximal LAD, the circumflex artery and the left main coronary artery (LMCA) extending back into the coronary sinus. A diagnosis of type 3 coronary dissection was made. The circumflex artery and the left coronary artery were stented, and then the LMCA was stented. Repeat intravascular ultrasound showed resolution of the dissection and TIMI-3 flow was achieved in all vessels. He underwent follow-up angiography in 1 month, which revealed patent stents with resolution of the aorto-coronary dissection. We report a rare case of iatrogenic aorto-coronary dissection that was successfully treated with unprotected left main percutaneous coronary intervention strategy alone and review the pertinent literature.
authors.affiliation: Division of Cardiology, Bridgeport Hospital, 267 Grant Street, Bridgeport, USA.
authors.forename: Avinash
authors.initials: A
authors.lastname: Murthy
authors.affiliation: Division of Cardiology, Bridgeport Hospital, 267 Grant Street, Bridgeport, USA.
authors.forename: Arti
authors.initials: A
authors.lastname: Singh
authors.affiliation: Division of Cardiology, Bridgeport Hospital, 267 Grant Street, Bridgeport, USA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Tuohy
keywords: Aorto-coronary dissection; IVUS; Left main coronary artery stenting; PCI