Iatrogenic Left Main Coronary Artery Dissection Treated with Bare Metal Stents: A Case with Twelve Years Angiographic Follow-up

Abstract

Complications during the course of Percutaneous Coronary Interventions (PCI) are common. One of the complications is iatrogenic Left Main Coronary Artery (LMCA) dissection, which is considered as lethal in nature and prevails in around 0.07% PCI cases. Timely diagnosis and immediate revascularisation is mandatory to manage LMCA dissection in order to avoid worsening of patient’s haemodynamic condition and to re-establish antegrade coronary blood flow. Here, the author report a case of catheter-induced iatrogenic LMCA dissection developed during stenting of a lesion in Left Anterior Descending (LAD) coronary artery of a 32-year-old male patient. The patient was managed by implantation of two Matrix (Sahajanand Medical Technologies, Pvt., Ltd., Surat, India) Bare Metal Stents (BMS) using double barrel technique to treat the dissection in left main coronary bifurcation. The patient was regularly followed-up and even after 12 years of the index procedure, the angiographic data revealed good patency of stents in LMCA without any major cardiac events.

Keywords

• bail-out technique
• bifurcation
• double barrel technique
• simultaneous kissing technique