Iatrogenic coronary intrastent dissection treated with a drug-eluting balloon: Case report

Author(s): Marek M. Rogowski, Kaffer Kara

Introduction: Intrastent dissection is a unique and rare form of coronary dissection and can occur in both bare metal and drug-eluting stents. The literature data regarding prevalence, treatment, and patients’ outcomes are limited to case reports and report series. Case presentation: This paper illustrates a rare case of iatrogenic intrastent dissection (type B according to The National Heart, Lung, and Blood Institute) that occurred during a percutaneous coronary intervention. Intravascular ultrasound revealed a tear of the drug-eluting stent neointima. This was treated safely with a prolonged dilatation with a drug-eluting balloon. The primary result was excellent. During the intervention, the patient remained asymptomatic and was discharged the next day for dual anti-platelet therapy. The invasive follow-up three months later showed a very good result, both angiographically and in intravascular ultrasound. Conclusion: This case demonstrates the usefulness and clinical safety of drug eluting balloons in coronary intrastent dissection.