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Focal intramural hematoma as a potential pitfall for iatrogenic aortic dissection during subclavian artery stenting: A case report

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World Journal of Clinical Cases 2021年第32期9卷 10033-10039页

作者： Yu Zhang Jun-Wei Wang Ge Jin Bo Liang Xin Li Yong-Tao Yang Qun-Ling Zhan Department of Interventional Radiology The Fifth People’s Hospital of ChongqingChongqing 400062China Department of Neurology The Fifth People’s Hospital of ChongqingChongqing 400062China

BACKGROUND iatrogenic aortic dissection(IAD)is a rare but fatal complication of interventional treatment for the proximal supra-aortic large *** cases of IAD after endovascular treatment of subclavian artery have been ***,the pathogenesis of IAD is still *** we report a patient with IAD following a balloon expandable stent implanted into the left subclavian artery(LSA).CASE SUMMARY An 84-year-old man with a history of hypertension was admitted to the Neurology Department of our hospital complaining of dizziness and gait disturbance for more than 1 *** tomography angiography of the head and neck showed severe stenosis at the proximal LSA and the origin of the left vertebral *** resonance diffusion-weighted imaging of the brain revealed subacute infarctions in cerebellum,occipital lobe and medulla *** suffered a Stanford type B aortic dissection after the proximal LSA angioplasty with a balloon expandable *** endovascular aortic repair was performed immediately with the chimney technique and he was discharged 20 d *** exploring the pathogenesis with multimodal imaging analysis,an easily neglected focal intramural hematoma(IMH)in the aorta near the junction of the LSA was found to be the main cause of the *** risk of IAD should be sufficiently evaluated according to the characteristics of aortic arch lesions before the proximal LSA *** Focal aortic IMH is a potential risk factor for IAD during a seemingly simple stenting of the proximal LSA.

关键词： Intramural hematoma Subclavian artery stenting iatrogenic aortic dissection Case report

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Successful conservative management of Class III iatrogenic aortic dissection

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Journal of Geriatric Cardiology 2018年第3期15卷 235-237页

作者： Wai Kin Chi Gary Tse Bryan PY Yan Department of Medicine and Therapeutics Faculty of Medicine The Chinese University of Hong Kong Hong Kong China Division of Cardiology Prince of Wales Hospital Shatin Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine The Chinese University of Hong Kong Hong Kong China

iatrogenic aortic dissection （IAD） is a rare complication of percutaneous coronary intervention （PCI） with an estimated incidence of 0.02%--0.04%. lAD occurs more frequently in the setting of urgent PCI for acute myocardial infarction （AMI）（0.19%） than for elective procedures （0.01%）.[11 The mortality risk associated with IAD is high （16%） and is comparable to that for spontaneous aortic dissection （16%）.Urgent surgery is the treatment of choice for extensive dissection or hemodynamic instability. In this report, we present a case of severe IAD that was managed conservatively with good clinical outcome.

关键词： Conservative management iatrogenic aortic dissection Percutaneous coronary intervention

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