ArticleCardiology journal2024
Catheter-induced coronary artery and aortic dissections. A study of mechanisms, risk factors and propagation causes.
Article in Cardiology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 13 citations in OpenAlex.
- Morphology Matters: Persistent Iatrogenic Aorto-Coronary Dissection Despite Initial Sealing Treated with a Stent-in-Stent Bailout Strategy: A Case Report and Literature Review.Reports (MDPI) · 2026Article
- Iatrogenic Left Main Coronary Artery Dissection With Retrograde Aortic Extension During Complex Percutaneous Coronary Intervention in a Left-Dominant System: A Case Report.Clinical case reports · 2026Article
- Article
- Catheter-induced left main dissection during valve-in-valve TAVI: a rare complication of coronary protection strategy.European heart journal. Case reports · 2025Article
- Circulatory Disturbances in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: Mechanisms, Management, and Outcomes.Journal of clinical medicine · 2025Review
- Iatrogenic Aortocoronary Dissection: Management and Outcomes.JACC. Case reports · 2025Article
- Management of Catheter-Induced Coronary Artery Dissection Leading to Extensive Bidirectional Intramural Hematoma.JACC. Case reports · 2025Article
- Clinical expert consensus document on bailout algorithms for complications in percutaneous coronary intervention from the Japanese Association of Cardiovascular Intervention and Therapeutics.Cardiovascular intervention and therapeutics · 2025Article
- A rare case of right coronary artery dissection during routine left heart catheterization.Global cardiology science & practice · 2024Article
- Forewarned Is Forearmed: Machine Learning Algorithms for the Prediction of Catheter-Induced Coronary and Aortic Injuries.International journal of environmental research and public health · 2022Article
- Floating wire assisted device retrieval-a novel technique for prevention of guide-related coronary injury.Indian heart journalArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOnly the incidence, management, and prognosis of catheter-induced coronary artery and aortic dissections have been systematically studied until now. We sought to evaluate their mechanisms, risk factors, and propagation causes.
methodsElectronic databases containing 76,104 procedures and complication registries from 2000-2020 were searched and relevant cineangiographic studies adjudicated.
resultsNinety-six dissections were identified. The overall incidence was 0.126%, and 0.021% for aortic injuries. The in-hospital mortality rate was 4.2%, and 6.25% for aortic dissections. Compared to the non-complicated population, patients with dissection were more often female (48% vs. 34%, p = 0.004), with a higher prevalence of comorbidities such as hypertension (56% vs. 25%, p < 0.001) or chronic kidney disease (10% vs. 4%, p = 0.002). They more frequently presented with acute myocardial infarction (72% vs. 43%, p < 0.001), underwent percutaneous coronary intervention (85% vs. 39%, p < 0.001), and were examined with a radial approach (77% vs. 65%, p = 0.011). The most prevalent predisposing factor was small ostium diameter and/or atheroma. Deep intubation for support, catheter malalignment, and vessel prodding were the most frequent precipitating factors. Of the three dissection mechanisms, 'wedged contrast injection' was the commonest (the exclusive mechanism of aortic dissections). The propagation rate was 30.2% and led to doubling of coronary occlusions and aortic extensions. The most frequent progression triggers were repeat injections and unchanged catheter. In 94% of cases, dissections were inflicted by high-volume operators, with ≥ 5-year experience in 84% of procedures. The annual dissection rate increased over a 21-year timespan.
conclusionsCatheter-induced dissection rarely came unheralded and typically occurred during urgent interventions performed in high-risk patients by experienced operators.
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