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Case Reports
. 2020 Aug;48(8):300060520943789.
doi: 10.1177/0300060520943789.

Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery

Peijian Wang  1 , Qiulin Wang  1 , Chen Bai  2 , Peng Zhou  1
Affiliations
Case Reports

Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery

Peijian Wang et al. J Int Med Res. 2020 Aug.

Abstract

An aberrant right subclavian artery is a congenital aortic arch anomaly in which the right subclavian artery originates from the proximal descending aorta. The presence of an aberrant right subclavian artery can make right transradial coronary interventions more difficult and even lead to complications. Iatrogenic intramural hematomas and dissection of aberrant right subclavian arteries during transradial coronary angiography have been previously reported. We herein report a case of iatrogenic aortic dissection following attempts to perform right transradial coronary angiography in a patient with an aberrant right subclavian artery. Clinicians should be vigilant for the presence of an aberrant right subclavian artery during right transradial coronary angiography and ensure gentle manipulation of wires and catheters to avoid complications.

Keywords: Aberrant right subclavian artery; aortic dissection; complications; iatrogenic; intramural hematoma; transradial coronary angiography.

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Figures

Figure 1.
Figure 1.
Aortic dissection following attempts to perform right radial angiography in a patient with an aberrant right subclavian artery. (a) Multidetector computed tomography scans showing aortic dissection (arrows, upper panel) with right renal artery involvement (arrows, lower panel). (b) Three-dimensional reconstruction showing the aberrant right subclavian artery (arrows) and the aortic dissection with the poorly perfused right kidney.
Figure 2.
Figure 2.
Eight-month follow-up. (a) Multidetector computed tomography scans showing aortic dissection (arrows, upper panel) with right renal artery involvement (arrows, lower panel). (b) Three-dimensional reconstruction showing the aortic dissection with the poorly perfused right kidney.
See this image and copyright information in PMC

References

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Publication types

Supplementary concepts