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Journal of Case Reports
Guiding Catheter-Induced Dissection of the Left Main Coronary Artery: Percutaneous Coronary Intervention or Surgery?
Santosh Kumar Sinha, Vinay Krishna 
Department of Cardiology, LPS Institute of Cardiology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India.
Corresponding Author:
Dr Santosh Kumar Sinha
Email: fionasan@rediffmail.com
Received: 10-MAY-2020 Accepted: 21-AUG-2020 Published Online: 20-NOV-2020
DOI: http://dx.doi.org/10.17659/01.2020.0063
Abstract
Background: Catheter-induced left main coronary artery (LMCA) dissection, though quite rare, is one of the most dreaded and life-threatening complication of coronary intervention and requires urgent management because if not promptly diagnosed and treated with myocardial revascularization, it can have fatal consequences. Case Report: Here, we report a case iatrogenic dissection of left main coronary artery by vigorous manipulation of extra backup (EBU) guiding catheter in a 73-year old male during revascularization of proximal left anterior descending artery which was successfully bailed out by stenting of left main artery using 4×23 mm Xience Prime everolimus eluting stent (Abott Vascular; USA) at 12 atm pressure achieving complete sealing of flap with TIMI III flow. Conclusion: Coronary artery dissection can be precipitated by catheter manipulation.
Keywords : Coronary Vessels, Dissecting Aneurysm, Iatrogenic Disease, Myocardial Revascularization, Stents.
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