Significant left main coronary artery disease from iatrogenic dissection during coronary angiography

Though atherosclerotic obstruction is the major cause of the obstructive left main coronary artery (LMCA) disease, it can be associated with iatrogenic dissection during coronary angiography. Here we report a case with severe LMCA stenosis due to catheter induced dissection in a 77-year-old man which was detected 9 months later. By careful review of the angiogram had taken at 9 months ago, the LMCA was injured by the diagnostic left Judkin's catheter during the first coronary angiography. The initial lesion was neglected and the dissection got worse with time. The patient was successfully treated with two drug-eluting stents by crushing technique and discharged without further complication. (C) 2008 Elsevier Ireland Ltd. All rights reserved.