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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Medical Imaging 1/2017

Follow-up of iatrogenic aorto-coronary "Dunning" dissections by cardiac computed tomography imaging

Zeitschrift:
BMC Medical Imaging > Ausgabe 1/2017
Autoren:
Stefan Baumann, Michael Behnes, Benjamin Sartorius, Tobias Becher, Ibrahim El-Battrawy, Christian Fastner, Uzair Ansari, Dirk Loßnitzer, Kambis Mashayekhi, Thomas Henzler, Stefan O. Schoenberg, Martin Borggrefe, Ibrahim Akin

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.
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