Iatrogenic Aortic Root Injury from Coronary Interventions: Early and Follow-up CT Imaging Findings

Aortic injury represents a rare but potentially fatal complication of invasive coronary angiography. The authors present a series of four patients with aortic injury after invasive coronary angiography and intervention (mean age, 71 years; three women). In three patients, CT showed subintimal staining from undiluted contrast media (CM) in the aortic root with no communication to the aortic lumen. Short-term follow-up CT showed resolution of CM staining in all patients. Classic aortic dissection occurred in one patient, with undiluted CM from invasive angiography in the false lumen in the aortic root. Preliminary evidence suggests that iatrogenic injury from invasive coronary angiography resulting in subintimal CM staining of the aortic wall at CT, without evidence of communication with the lumen of the aortic root, shows favorable short-term outcome. (c) RSNA, 2021