Catheter induced left main coronary artery stenosis: A rare complication of percutaneous coronary intervention

Introduction: Iatrogenic left main coronary artery lesion following percutaneous coronary intervention (PCI) is a rare complication. Bashour et al. first reported this complication more than twenty­three years ago. Fortunately, this was one of only a handful of cases reported in literature, in spite of the thousands of procedures performed every year. Case Series: We are reporting two cases of catheter induced left main coronary artery stenosis. One of the cases involved PCI to left anterior descending artery (LAD) and the 2nd to the left circumflex artery (LCX). Neither cases revealed significant plaque burden in the left main coronary artery (LMCA). The patients in both cases returned within three months with symptoms of angina, and were found to have critical left main disease, presumably induced by guide catheters. One patient underwent coronary artery bypass graft (CABG) and other had successful ostial left main PCI. Conclusion: Catheter induced left main coronary artery disease is a rare but serious complication of PCI, and should always be considered in any patient that returns with chest pain following PCI. Particular attention should be paid to catheter and device manipulation during the procedure to avoid this potentially calamitous complication.