Case report of dissection of the right coronary artery due to uncontrolled rotational movement of the guiding catheter: A twist in the story

Catheter-induced coronary artery dissection is a rare complication with potentially life-threatening consequences. It has been described in less than 0.1% of patients undergoing coronary angiography [1-3]. Technical reasons (type of catheter, catheter position, deep intubation) as well an anatomical/histological predisposition (ostial disease, vessel orientation, vessel size, type of collagen fibers) contribute to its development [4-7]. Contact between the tip of the catheter and the arterial wall promoting intimal disruption and subsequent penetration of contrast during the injection is the basic substrate for this phenomenon.