Revascularization methods in spontaneous coronary artery dissection: A focused review. [Review]
Revascularization methods in spontaneous coronary artery dissection: A focused review. [Review]
- 2017
Available in print through MWHC library: 2002 - present
Copyright (c) 2017 Elsevier Inc. All rights reserved. Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking. We highlight 4 cases of SCAD from our institution, review the literature with regard to percutaneous revascularization in this population, and propose a step-wise algorithm for percutaneous intervention strategies in managing higher-risk SCAD.
English
1878-0938
*Angioplasty, Balloon, Coronary/is [Instrumentation]
*Coronary Vessel Anomalies/th [Therapy]
*Percutaneous Coronary Intervention
*Vascular Diseases/cn [Congenital]
Adult
Algorithms
Coronary Angiography
Coronary Vessel Anomalies/dg [Diagnostic Imaging]
Critical Pathways
Decision Support Techniques
Drug-Eluting Stents
Female
Humans
Middle Aged
Percutaneous Coronary Intervention/is [Instrumentation]
Risk Factors
Treatment Outcome
Ultrasonography, Interventional
Vascular Diseases/dg [Diagnostic Imaging]
Vascular Diseases/th [Therapy]
MedStar Heart & Vascular Institute
Journal Article
Review
Available in print through MWHC library: 2002 - present
Copyright (c) 2017 Elsevier Inc. All rights reserved. Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking. We highlight 4 cases of SCAD from our institution, review the literature with regard to percutaneous revascularization in this population, and propose a step-wise algorithm for percutaneous intervention strategies in managing higher-risk SCAD.
English
1878-0938
*Angioplasty, Balloon, Coronary/is [Instrumentation]
*Coronary Vessel Anomalies/th [Therapy]
*Percutaneous Coronary Intervention
*Vascular Diseases/cn [Congenital]
Adult
Algorithms
Coronary Angiography
Coronary Vessel Anomalies/dg [Diagnostic Imaging]
Critical Pathways
Decision Support Techniques
Drug-Eluting Stents
Female
Humans
Middle Aged
Percutaneous Coronary Intervention/is [Instrumentation]
Risk Factors
Treatment Outcome
Ultrasonography, Interventional
Vascular Diseases/dg [Diagnostic Imaging]
Vascular Diseases/th [Therapy]
MedStar Heart & Vascular Institute
Journal Article
Review