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For patients with unprotected left main coronary artery (uLMCA) disease, the main accepted treatment is coronary artery bypass graft surgery (CABG) (1). Previously, percutaneous coronary intervention (PCI) for uLMCA disease was associated with relatively high procedural and post-procedural long-term unwanted events (2). Recently, this has been performed in clinical practice with increasing numbers, over several landmark studies, and similar outcomes when compared with CABG (3). The strategy for revascularization LMCA should be determined on a per-patient basis because of long-term risks. Furthermore, drug-eluting stents (DESs) with advanced procedural techniques and new antithrombotic drugs have increased the popularity and success of LMCA stenting (4). Of the elective procedures, there are reports of uLMCA stenting performed in high-surgical-risk patients or as the bailout process for procedure-related acute LMCA dissection (5). Percutaneous management of large vessels (>5 mm) has become a challenging process for interventional cardiologists because of limited commercial sizes of coronary stents. In this study, we present a case with catheter-induced uLMCA dissection successfully managed with a renal stent due to the large anatomical size of the LMCA.

An alternative urgent management for an iatrogenic dissection of a large left-main artery: Renal stent implantation