In: BMC Medical Imaging, 17 (2017), Nr. 64. pp. 1-9. ISSN 1471-2342

Preview

PDF, English Download (1MB) | Lizenz: Follow-up of iatrogenic aorto-coronary "Dunning" dissections by cardiac computed tomography imaging by Baumann, Stefan ; Behnes, Michael ; Sartorius, Benjamin ; Becher, Tobias ; El-Battrawy, Ibrahim ; Fastner, Christian ; Ansari, Uzair ; Loßnitzer, Dirk ; Mashayekhi, Kambis ; Henzler, Thomas ; Schoenberg, Stefan O. ; Borggrefe, Martin ; Akin, Ibrahim underlies the terms of Creative Commons Attribution 4.0

Abstract

Background: Iatrogenic aorto-coronary dissections following percutaneous coronary interventions (PCI) represent a rare but potentially life threatening complication. This restrospective and observational study aims to describe our in-house experience for timely diagnostics and therapy including cardiovascular imaging to follow-up securely high-risk patients with Dunning dissections.

Methods: Dunning dissections (DD) occurred during clinical routine PCIs, which were indicated according to current ESC guidelines. Diagnostic assessment, treatment and follow-up were based on coronary angiography with PCI or conservative treatment and cardiac computed tomography (cCTA) imaging.

Results: A total of eight patients with iatrogenic DD were included. Median age was 69 years (IQR 65.8–74.5). Patients revealed a coronary multi-vessel-disease in 75% with a median SYNTAX-II-score of 35.3 (IQR 30.2–41.2). The most common type of DD was type III (50%), followed by type I (38%) and type II (13%). In most patients (88%) the DD involved the right coronary arterial ostium. 63% were treated by PCI, the remaining patients were treated conservatively. 88% of patients received at least one cCTA within 2 days, 50% were additionally followed-up by cCTA within a median of 6 months (range: 4–8 months) without any residual.

Conclusion: Independently of the type of DD (I-III) it was demonstrated that cCTA represents a valuable imaging modality for detection and follow-up of patients with DDs.