Conservative Management of Iatrogenic Type a Aortic Dissection Occurring During Percutaneous Coronary Intervention.

El Mallouli, Mohamed;Liu, Chirine;Van Der Linden, Romain;Berdaoui, Brahim;Pintea Bentea, Georgiana
(2026) Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions — (2026)

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Authors
  • El Mallouli, Mohamedorcid-logo
    Author
  • Liu, Chirine
    Author
  • Van Der Linden, Romain
    Author
  • Berdaoui, Brahimorcid-logo
    Author
  • Pintea Bentea, GeorgianaUCLouvain
    Author
Abstract
Iatrogenic type A aortic dissection (TAAD) during percutaneous coronary intervention (PCI) is a rare but life-threatening complication, usually managed surgically. We report the case of a 59-year-old patient who developed an ascending aortic dissection extending to the proximal arch during left circumflex (LCX) chronic total occlusion (CTO) recanalization. Stenting of the LCX and left main coronary artery successfully sealed the entry site and stabilized the patient. Computed tomography revealed a false lumen occupying 51% of the aortic diameter, without involvement of supra-aortic branches. Conservative management was initiated with strict anti-impulse therapy and staged dual antiplatelet therapy. At 24 h, the false lumen regressed to 37%, with complete resolution by Day 7. In selected cases of iatrogenic TAAD during PCI, conservative management following successful sealing of the entry tear may represent a safe alternative to sugery.
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El Mallouli, M., Liu, C., Van Der Linden, R., Berdaoui, B., & Pintea Bentea, G. (2026). Conservative Management of Iatrogenic Type a Aortic Dissection Occurring During Percutaneous Coronary Intervention. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions. Accepted/in-press. https://doi.org/10.1002/ccd.70622 (Original work published 2026)