Abstract
Spontaneous coronary artery dissection (SCAD) treatment is to date a matter of debate and few data are available for the interventional cardiologists. In the present review we briefly report four representative clinical cases in which different strategies were carried out. Therefore, we discussed different tools and techniques currently available to treat SCAD presenting advantages and drawbacks of conservative approach, Drug Eluting Stent (DES) or bio-resorbable scaffolds implantation and cutting balloon angioplasty
Highlights
Spontaneous Coronary Artery Dissection (SCAD) is an acute spontaneous separation between the layers of the coronary artery wall, causing the formation of a false lumen with or without intimal rupture
Patients suffering SCAD show a smaller burden of coronary risk factors and are younger in age than the typical patients affected by atherosclerotic acute coronary syndromes[4,5]
Our group recently highlighted the unpredictability of SCAD and the importance of a close clinical surveillance following an initial conservative strategy. In this case series[9], among four patients with similar angiographic and clinical presentation, two cases experienced a malignant evolution with need of emergent percutaneous coronary intervention (PCI) and extensive stenting while in the other two cases complete angiographic healing was demonstrated in follow-up angiograms
Summary
Spontaneous Coronary Artery Dissection (SCAD) is an acute spontaneous separation between the layers of the coronary artery wall, causing the formation of a false lumen with or without intimal rupture. Acute Interventional Management of Spontaneous Coronary Artery Dissection: Case Series and Literature Review: International Cardiovascular Forum Journal. Coronary angiogram showed a severe and long narrowing from the proximal to the mid-distal segments of the right coronary artery (RCA), compatible with an angiographic type 2b SCAD pattern (according to the latest classification proposed[1], with TIMI 3 FLOW (Figure 1, Panel A).
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