ABSTRACT

Acute coronary dissections • Acute closure • Coronary perforation • Vessel rupture • Wire perforations • Pericardial drainage

ACUTE CORONARY DISSECTIONS

Historically the occurrence of a dissection following coronary angioplasty had a double connotation. In a classic study by Gruentzig the best long-term results occurred in lesions which had a residual gradient less than 15 mmHg and had a visible dissection.1 On the other side the presence of a dissection was a risk factor for acute and subacute vessel closure and this was one of the main reasons for referral to emergency surgery.2-6 The National Heart, Lung and Blood Institute (NHLBI) classification system for intimal tears, developed by the Coronary Angioplasty Registry, is proposed for the classification of dissection types (dissections are graded based upon their angiographic appearances as types A to F).3