CTICasesIatrogenic Aortic Dissection from Catheter Ablation
Imaging findings
Contrast-enhanced CT demonstrates an extensive, retrogradely propagated aortic dissection extending from the right external iliac artery all the way to the aortic root. The dissection was initiated by wire or catheter manipulation during a retrograde femoral arterial approach for ventricular tachycardia ablation. Non-contrast CT did not show a clear hyperattenuating intramural hematoma prior to contrast administration.
Key takeaways
Iatrogenic aortic dissection is a rare but devastating complication of endovascular procedures, such as catheter ablations or coronary interventions. A retrograde arterial approach carries a risk of arterial wall injury, which can propagate proximally to involve the entire aorta and coronary ostia, requiring emergent surgical repair of the ascending aorta.
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