Introduction. The aim of this study was to examine the incidence and risk factors of catheterization-related CI in the contemporary era, using diffusion-weighted magnetic resonance imaging. Methods. We retrospectively analyzed consecutive 84 patients who underwent MRI (magnetic resonance imaging) after 2.81 ± 2.4 days (mean ± SD) of catheterization via aortic arch. We categorized the patients by the presence or absence of acute CI determined by diffusion-weighted MRI and analyzed the incidence and predictors. Results. Of 84 patients that underwent MRI after catheterization, acute CI was determined in 27 (32.1%) patients. In univariate analysis, dyslipidemia, age, coronary artery disease, antiplatelet agents, number of catheters used, urgent settings, and interventional procedures were significantly different. Multivariate analysis revealed dyslipidemia (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.41–16.03; p = 0.01), higher age (OR, 1.09; 95% CI, 1.007–1.19; p = 0.03), and the number of catheters used (OR, 2.21; 95% CI, 1.21–4.36; p = 0.01) as independent predictors of the incidence of catheterization-related acute CI. Conclusions. Dyslipidemia, higher age, and number of catheters used were independent predictors for acute CI after catheterization. These findings imply that managing dyslipidemia and comprehensive planning to minimize the numbers of catheters are important.

SUMMARYA 79-year-old man was referred to the emergency room following a sudden episode of 'spitting blood', with a blood pressure of 128 (systolic) and 75 mm Hg (diastolic) and a heart rate of 60 bpm. His medical history included the treatment of gastric cancer and untreated hypertension. At that time, his symptoms were limited without any chest, back or abdominal pain. After a presentation of haemoptysis was confirmed, a chest radiograph revealed an air-fluid level (a 'niveau') that was continuous towards the enlarged thoracic aorta and the thoracic cavity. Contrast-enhanced CT was subsequently performed, and revealed an aortic dissection and a pneumothorax adjacent to the dissection, accompanied by blood pooling in the thoracic cavity. The patient died 40 min after the admission to the emergency room due to an additional haemoptysis. The autopsy confirmed the diagnosis of a ruptured aortic dissection with pneumothorax.

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