0.014″ soft-tip floppy Marker wire (BMW; Abbott Vascular,Santa Clara, CA, USA) unable to pass the RCA and after repeated contrasting, the RCA was completely occluded. AL 1 guide catheter was replaced by JR 4 and after this the guide wire was successfully advanced into the distal and after, the stenting of the aorto-ostial part was performed by 4.0 x 18 mm bare metal stent. The final result was satisfactory. In the RCA TIMI 3 flow and by angiography further signs of continuing dissection were not detected.
Iatrogenic aortic dissection of the ascending aorta (Type A) may be life-threatening, requiring surgical replacement of the diseased vessel, to avoid pericardial effusion, coronary artery dissection, or acute aortic regurgitation 1,2. According to our experience, retrograde dissection into the aorta during percutaneous coronary intervention (PCI) can be sealed with a coronary stent that covers the coronary ostium and should be treated conservatively in most circumstances, unless complication like extension of dissection into other vessels or pericardial effusion or hemodynamic instability occurs.