Management of Catheter-Induced Coronary Artery Dissection Leading to Extensive Bidirectional Intramural Hematoma

Spreading epidemic of atherosclerotic coronary artery disease coupled with huge technical advancement, has led to steep rise in percutaneous coronary interventions. The coronary intervention might be complicated with catheter-induced coronary artery dissection and intramural hematoma. It usually spread antegradely along the course of coronary artery but occasionally retrograde extension into the aorta leads to horrible visual impression. Its size might vary from small to voluminous causing minimum hindrance to complete cessation of flow. Thus, it may manifest as asymptomatic observation to hemodynamic collapse. Quick recognition and prompt bailout stenting of the affected coronary artery is the most common treatment strategy.