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Left Internal Mammary Artery Dissection during Percutaneous Coronary Intervention in Hypertensive Patients

Marco Vatrano, Roberto Ceravolo, Giuseppe Dattilo, Vincenzo Antonio Ciconte and Egidio Imbalzano

Left Internal Mammary Artery (LIMA) dissection is a potential catastrophic complication of percutaneous coronary intervention (PCI) rarely observed in hypertensive patients. There are very few reports but the paucity of data regarding the incidence capture the imagination more than other coronary dissections. Additionally, for the management of this iatrogenic complication there are no evidence-based guidelines to assist the operator. We present a case of two diagnostic catheter-induced dissections of LIMA successfully resolved with long multiple stenting, and review the existing literature. In our opinion, these case reports describe a very rare condition in hypertensive patients with some practical tips on how to avoid them, whereas there are very few published data. Moreover, we have shown that stenting has been used to solve a potentially deadly procedural complication, in a basal extremely serious clinical situation.