Coronary artery dissection after transluminal angioplasty. Possible deleterious effects of treatment with intracoronary streptokinase.

Percutaneous transluminal coronary angioplasty (PTCA) is a nonsurgical alternative in the management of selected patients with coronary artery disease. Intimal dissection is the mechanism by which PTCA dilates coronary obstructions. Acute vessel occlusion is a rare but severe complication. Vessel patency can often be restored by fibrinolytic therapy when occlusion occurs immediately after angioplasty. A case of a patient with coronary dissection after PTCA and delayed obstruction, possibly aggravated by streptokinase is presented.