PMC3915963_01
Left main dissection (1) extending to the ascending aorta (2) was visualized in coronary angiography after successful angioplasty of the left anterior descending artery (3). Left main dissection did not compromise blood flow
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After successful stent deployment in the proximal segment of the LAD, a dissection in the distal left main coronary artery was noticed (Figure 1).
A - A CT scan of the chest. Ascending aorta (1) is dissected with thrombus partially filling false aneurysm. In the descending thoracic aorta (2) thrombus is filling the whole false lumen. B - A CT scan of the abdomen. Abdominal aorta at the level of the celiac trunk ( ) is dissected while maintaining flow through both true and false lumen
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The aortic wall was slightly dilated and its external diameter did not exceed 45 mm in any segment (42 mm in the ascending aorta, 35 in the descending thoracic and 29 mm in the abdominal aorta) (Figures 2A and 2B ).
36-month follow-up CT scan with complete resolution of the dissection in both the thoracic (A) and abdominal (B) segment. True lumen of the aorta, but not the external diameter, especially its ascending part (1), is markedly enlarged after 36 months as compared with the image obtained just after iatrogenic injury
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The last CTA (36 months after the unfortunate PCI) revealed a complete occlusion of the false lumen of the aorta (Figure 3).