Ramasamy A, Bajaj R, Jones DA, et al. - Findings demonstrate iatrogenic catheter-induced ostial coronary artery dissection (ICOCAD) as a life-threatening complication of coronary angiography, with a rare occurrence. For most of the patients with good clinical results, timely recognition as well as prompt bailout percutaneous coronary artery intervention represents a safe choice.

• This study included 55,968 patients who underwent coronary angiography and screening for ICOCAD.

• For ICOCAD, estimated overall prevalence was 0.09% (51/55,968 patients); 75% (n = 37) of cases were due to guide catheters.

• Right coronary artery was involved in half cases, and two-thirds of ICOCAD were high grade (type D, E, and F).

• Most of the cases were type F dissections (66%), of which two third happened in women in their 60s.

• Percutaneous coronary intervention was the main treatment (42/51; 82%), and the rest of the patients received coronary artery bypass grafting (3/51; 6%) or managed conservatively (6/51; 12%).

• During index admission, three patients died, while safe discharge was achieved in 48/51 cases (94.1%) without further mortality over a median follow-up of 3.6 years.