Tejas Patel, MD | Sanjay Shah, MD | Samir B. Pancholy, MD

Chapter 4: Coronary and Aortic Root Dissections

In the modern era, as interventional cardiologists continue to treat high-risk patients, coronary dissections continue to occur before and after stent placement. Although the incidence of coronary artery dissection requiring emergency surgery in the stent era is <0.2%, it remains imperative that this complication be recognized during the initial procedure, as early treatment improves vessel patency and patient outcomes.1-5 There are generally three causes of iatrogenic coronary dissection: localized guide catheter-induced dissection, spiral dissection, and stent edge dissection. Aortic root dissection is guide-catheter induced unless proven otherwise. Optimal management requires proper angiographic identification and definitive intervention to avoid progression and maintain vessel patency.4,5

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