Commentary - (2023) Volume 9, Issue 12
Received: 29-Nov-2023, Manuscript No. IPIC-23-18769; Editor assigned: 01-Dec-2023, Pre QC No. IPIC-23-18769 (PQ); Reviewed: 15-Dec-2023, QC No. IPIC-23-18769; Revised: 20-Dec-2023, Manuscript No. IPIC-23-18769 (R); Published: 27-Dec-2023, DOI: 10.21767/2471-8157.9.12.115
In the realm of cardiovascular interventions, catheter-based procedures have revolutionized the diagnosis and treatment of various cardiac conditions. However, amidst the remarkable advancements, a rare but potentially serious complication known as catheter-induced dissection emerges as a concern. This intricate phenomenon, involving the unintended separation of layers within blood vessel walls due to catheter manipulation, warrants comprehensive exploration. From understanding its mechanisms to management strategies, this comprehensive review navigates the landscape of catheter-induced dissection, shedding light on its complexities and clinical implications. Catheter-induced dissection typically occurs when the manipulation of a catheter within a blood vessel leads to the separation of the intimal and medial layers of the vessel wall, creating a false lumen. The forces exerted during catheterization, such as shearing, stretching, or mechanical trauma, can compromise the integrity of the vessel wall, initiating the dissection. The clinical presentation of catheter-induced dissection varies based on the location and severity. It may range from asymptomatic cases detected incidentally on imaging studies to symptomatic scenarios, including chest pain, limb ischemia, neurological deficits, or even life-threatening complications like vessel occlusion or rupture. Vessels with pre-existing structural abnormalities, such as atherosclerosis, aneurysms, or vessel tortuosity, pose an increased risk of dissection during catheter manipulation. Aggressive catheter manipulation, excessive force during device delivery, or using larger-sized catheters than the vessel diameter may heighten the risk of inducing dissection. Underlying vascular fragility, connective tissue disorders, or coagulopathies may predispose individuals to catheter-induced dissection. Accurate and timely diagnosis of catheter-induced dissection is pivotal for appropriate management. Digital subtraction angiography remains the gold standard for diagnosing catheter-induced dissection, enabling real-time visualization of vessel morphology and delineation of the dissection flap. Intravascular Ultrasound (IVUS) or Optical Coherence Tomography (OCT) provide high-resolution imaging, aiding in precise assessment of vessel wall integrity and identifying dissections not evident on angiography. Non-invasive imaging modalities like Computed Tomography (CT) angiography or Magnetic Resonance Imaging (MRI) can offer detailed anatomical information and aid in the evaluation of vascular complications. Asymptomatic or clinically stable dissections may be managed conservatively with close monitoring and antiplatelet therapy. Small, uncomplicated dissections may spontaneously heal over time. For symptomatic or complicated dissections, endovascular procedures like balloon angioplasty, stent placement, or covered stent grafts may be employed to restore vessel patency and support vessel wall integrity. Severe or life-threatening dissections, particularly those involving vital vessels or organ ischemia, may necessitate open surgical repair to address the vascular injury. Thorough assessment of patient history, including vascular risk factors and imaging studies, aids in identifying patients at higher risk of dissection. Adherence to gentle catheter handling techniques, avoiding excessive force or aggressive manipulation, reduces the risk of vessel injury. Utilizing advanced imaging modalities, such as IVUS or OCT, during catheterization procedures enhances visualization and helps prevent inadvertent vessel injury. Despite being a rare complication, catheter-induced dissection necessitates vigilance and prompt recognition during cardiovascular procedures.
None.
The author’s declared that they have no conflict of interest.
Citation: Moody H (2023) Catheter-Induced Dissection: Unraveling a Rare but Critical Complication in Cardiovascular Procedures. Interv Cardiol J. 9:115.
Copyright: © 2023 Moody H. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
