• Conservative management of severe coronary artery hematoma and dissection following stent implantation

    Highlights

    • We experienced a case of severe dissection and hematoma following stent implantation.
    • Additional stent implantation and/or balloon dilatation to make a re-entry are the options for the dissection and hematoma.
    • The conservative management can be an option for the severe edge dissection and hematoma following stent implantation.

    Abstract

    Severe dissection and hematoma following stent implantation can cause acute vessel closure, which requires an immediate bailout procedure. However, bailout from such a situation may not be easy, especially when the hematoma extends to the distal segment of a coronary artery. We present a case of 73-year-old woman with effort angina who underwent PCI to the right coronary artery (RCA). Following stent implantation, there was a massive hematoma from the distal edge of the stent. We tried to create re-entry at the distal part of the hematoma, but were not successful. We managed her conservatively without additional stent placement or creating re-entry. Follow-up coronary angiography on day 68 showed excellent coronary flowIntravascular ultrasound demonstrated complete healing of the hematoma. A hematoma caused by edge dissection is a challenging complication. Additional stent implantation to cover the entire length of the hematoma and/or cutting balloon dilatation to create re-entry are options; however, these procedures may worsen the situation. Our case clearly showed healing of dissection and hematoma without creating re-entry or additional stent implantation. Conservative management should be considered an option for severe edge dissection and hematoma following stent implantation.

    Author bio

    Cardiovascular Revascularization Medicine, 2019-04-01, Volume 20, Issue 4, Pages 347-350, Copyright © 2018 Elsevier Inc.

     

    Source:

    Read the full article on Science Direct: Conservative management of severe coronary artery hematoma and dissection following stent implantation

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