Images in a 72-year-old female patient (patient 3) undergoing
intervention for recanalization of a subtotal (99%) in-stent restenosis
of the right coronary artery (RCA). There was focal extravasation of
contrast media at the RCA ostium (yellow arrow in A). The
extravasation was immediately treated with stent extension to the RCA
ostium. Thirty minutes after the intervention, CT demonstrated a small,
focal, crescent-shaped hyperattenuation of the aortic wall adjacent to
the RCA ostium, compatible with subintimal contrast media staining
(Dunning I; yellow arrow on B, axial and C,
contrast-enhanced CT images and D, multiplanar reformation
of contrast-enhanced CT images). Follow-up CT after 24 hours showed
complete resolution of the undiluted contrast media accumulation (yellow
arrow on E, axial non–contrast-enhanced and
F, contrast-enhanced CT images).