Clinical insights into iatrogenic aortocoronary dissection: a case series of conservative and fatal outcomes

Iatrogenic aortocoronary dissection is a rare but life-threatening complication during coronary angiography or percutaneous coronary intervention. We report two cases illustrating distinct clinical outcomes. The first case involved a right coronary artery dissection managed conservatively, followed by successful delayed stenting. The second case involved extensive dissection of the left main coronary artery, leading to vessel occlusion and fatal cardiac arrest despite emergent intervention. These cases highlight the critical importance of early recognition, careful procedural technique, and individualized management strategies. They also emphasize the need for strict adherence to guideline-directed decision-making to optimize patient safety and outcomes in complex coronary interventions.