Catheter-induced Coronary Dissection Research Articles

Technical success and long-term experience of a novel radial guide-catheter shape: the JCLRAD.

Percutaneous coronary intervention (PCI) via the transradial route has been widely adopted over the transfemoral route, but guide catheter selection remains limited. We present our experience with a novel guide catheter design, the Judkin’s Curve Left- Radial (JCLRAD, Medtronic), which is optimized for transradial PCI to the left coronary system. Sequential patients who underwent PCI using the JCLRAD catheter over a 3-year period (October 1, 2017 to November 1, 2020) were included in the analysis. Prospectively collected data were extracted from the institutional NCDR CathPCI registry with supplemental medical record review to collect clinical and procedural data. PCI was performed in 2347 patients and 4070 lesions using the JCLRAD guide catheter. The mean age was 65.5 ± 11.7 years, and 72.1% of the population were male; 52.5% of patients presented with acute coronary syndrome. The lesion complexity was high (66.7% Class B2/C by ACCAHA classification) with a 7% use of atherectomy. Procedural success was 99.6% with no identified cases of iatrogenic catheter-induced coronary dissection. In this single-center retrospective study, the use of the JCLRAD was associated with a high success rate and low rates of complications, including no guide catheter-induced dissection in a cohort of patients with complex coronary anatomy. This is the first-reported large clinical experience with this novel radial left coronary system guide catheter.

Catheter-induced coronary dissection during optical coherence tomography investigation

Catheter-induced coronary dissection during optical coherence tomography investigation

Catheter-induced in-stented segment coronary dissection

Coronary angiography can lead to different kinds of complications. Catheter-induced coronary dissection is one of the most feared of them. It is uncommonly reported and may result in ischemic events ranging from angina to death. We report a case of a woman admitted to the hospital due to progressive effort angina who had a complication during percutaneous coronary intervention not previously reported. It is a usual thinking that a coronary artery stented segment would not be prone to dissect either spontaneously or catheter-induced. This report describes a catheter-induced in-stented segment coronary dissection and a discussion if the dissection line involving the left anterior descending coronary artery stented segment occurred between the stent and the intimal hyperplasia or between the stent and the adventitia.

A Child Case of Acute Right Coronary Obstruction Due to Catheter-Induced Coronary Dissection:

We report on a 10-year-old child who suffered from acute right coronary obstruction due to catheter-induced coronary dissection. Immediate placement of a perfusion catheter into the obstructed right coronary artery and subsequent overnight reperfusion allowed successful recovery of the right coronary artery lumen without implantation of a stent. Follow-up angiography demonstrated spontaneous regression of the dissected coronary artery and normal right and left ventricular wall motion. The indication of stent implantation should be carefully determined in a child case of iatrogenic coronary dissection because stenting may induce coronary stenosis during growth.

Imaging of left main trauma during diagnostic cardiac catheterization with intravascular ultrasound.

In this case report the occurrence of a catheter-induced coronary artery dissection is described. In our patient, angiography showed a mushroom-shaped exudate above the left main coronary artery. Intravascular ultrasound revealed a circular dissection with a huge false lumen connected to the true lumen by a small intimal tear. A brief review of the literature on catheter-induced coronary dissection is included. We believe that this case report provides a good illustration of the need for careful reviewing of indications for angiography. Although procedural risks are low, angiography remains an invasive diagnostic test with the potential to cause severe complications.