Revascularization methods in spontaneous coronary artery dissection: A focused review. [Review]

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 18(7):544-548, 2017 Oct - Nov.PMID: 28529093Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *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]Year: 2017Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: 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.All authors: Ben-Dor I, Lee ROriginally published: Cardiovascular Revascularization Medicine. , 2017 May 12Fiscal year: FY2018Fiscal year of original publication: FY2017Digital Object Identifier: Date added to catalog: 2017-05-26
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28529093 Available 28529093

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.

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