{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:00:37Z","timestamp":1790240437640,"version":"4.1.0"},"reference-count":89,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82300439"],"award-info":[{"award-number":["82300439"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2026ZD0557603"],"award-info":[{"award-number":["2026ZD0557603"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Percutaneous coronary intervention (PCI) has become a cornerstone treatment for symptomatic coronary artery disease. Although generally safe and effective, PCI may still lead to serious complications such as coronary artery dissection or vessel perforation. Coronary artery dissection can arise spontaneously or be triggered by catheter-based procedures, the latter referred to as iatrogenic coronary artery dissection (ICAD). ICAD, while uncommon, carries significant procedural and prognostic implications; catheter-induced ostial dissection has been reported in approximately 0.09% of coronary angiographic procedures, while 30-day mortality reached 20.8% in a high-risk surgical cohort of patients with PCI-related coronary injuries. Given the increasing use of coronary interventions and the complexity of contemporary lesions, early recognition and accurate characterization of ICAD have become critical. Advances in intravascular imaging\u2014particularly intravascular ultrasound and optical coherence tomography\u2014have improved the ability to identify dissection morphology, understand underlying mechanisms, and guide real-time management. Furthermore, accumulating evidence highlights the role of patient characteristics, lesion anatomy, catheter\/device interactions, and procedural techniques in shaping ICAD risk. This narrative review integrates current knowledge on the classification, imaging features, risk determinants, management strategies, and prevention of ICAD, providing a structured framework to support safer and more precise coronary intervention.<\/jats:p>","DOI":"10.3389\/fcvm.2026.1910377","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:10:30Z","timestamp":1790237430000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Iatrogenic coronary artery dissection: detection, management, and prevention"],"prefix":"10.3389","volume":"13","author":[{"given":"Yanyou","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Abdominal Ultrasonography, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuxiu","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Echocardiography, The Affiliated Hospital of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Yan","sequence":"additional","affiliation":[{"name":"Outpatient Nursing Unit, The 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