TAP-stenting as bail-out strategy for iatrogenic dissection of left main bifurcation

Abstract

Iatrogenic coronary dissection is a rare but potentially catastrophic complication of percutaneous coronary intervention. The proximal left anterior descending artery (LAD) dissection may extend into distal left main bifurcation which may further engulf left circumflex artery (LCx). Here, we report a case of a 69-year-old male where dissection at proximal edge of well deployed stent led to total closure of left circumflex artery causing hemodynamic compromise. It was bailed out using T-and-protrusion (TAP) stenting where LAD and LCx were stented using 3.5x12mm and 3x24 mm sirolimus-eluting stent (Yukon Choice, Translumina) respectively. TAP technique is a feasible and reasonable management strategy for immediate bail-out stenting for this lethal complication