Dissection
Endothelial dissection. A technical accident during angiography, usually the result of a guide wire (or the catheter) damaging the endothelium and entering the vessel wall without being spotted. If the guide wire (or catheter) is pushed further, a kind of "pocket" is made, showing as a "filling defect" in the image. The risk of dissection is greater in narrow, tortuous vessels with many or large plaques, where catheterisation is particularly difficult. The presence of endothelial dissection should not be confused with a thrombus in angiography. It may be a problem even for the most experienced specialist to differentiate with certainty between a thrombus and a dissection during radiological or interventional procedures. Dissections also can occur spontaneously, e.g. aortic dissection.
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