Catheter-induced
coronary dissection is rare albeit life threatening complication of coronary
angiography and angioplasty. Based on available studies the incidence of
coronary dissection involving the aortic root is about 0.02 – 0.07%. Some of
the predisposing conditions are hypertension, Marfan syndrome, congenital
unicuspid and bicuspid aortic valves.It is more commonly associated with
coronary angioplasty than with diagnostic angiography.
RCA angioplasty carries
a higher risk for aorto –coronary dissection as compared to left coronary
artery angioplasty, the mechanism of which is still not clear. Some of the
proposed theory regarding the higher frequency seen in RCA are greater diameter
of the left coronary artery than the right, the acute angle between left
coronary artery and the ascending aorta compared to nearly right angle for
right coronary artery, and more smooth muscles and collagen tissues in left
coronary sinus. Read more.................
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