Optical Coherence Tomography–Guided Full Plastic Jacket in Spontaneous Coronary Artery Dissection

Ramalho, Ana Rita; Marques, João Silva; Oliveira-Santos, Manuel; Matos, Vítor

doi:10.1016/j.jcin.2016.10.028

Cited by 7 publications

(2 citation statements)

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“…Intracoronary imaging (IVUS/OCT) has theoretical advantages over coronary angiography; nonetheless, a large coronary imaging series confirmed a small number of complications (5 of 63 cases) directly attributable to intracoronary imaging, resulting in either false lumen propagation, impaired flow, or iatrogenic dissection. 44,45 When compared to OCT, imaging with IVUS does not require high-pressure injection of contrast and presents with a safer diagnostic profile. However, its lower spatial resolution makes it challenging to distinguish SCAD from lipid-rich atheroma (a key differential diagnosis).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Oliveira¹,

Vasconcelos²,

Abreu³

et al. 2023

J Transcat Intervent

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Background: Although it is a poorly known disease, spontaneous coronary artery dissection is an important and frequently underdiagnosed cause of non-atherosclerotic acute coronary syndrome, particularly in women. The objective of this study was to characterize a consecutive sample of patients diagnosed with spontaneous coronary artery dissection with respect to predisposing and precipitating factors; clinical and angiographic presentation; management; occurrence of adverse cardiac events; recurrence; and de novo spontaneous coronary artery dissection. Methods: Longitudinal, observational, retrospective, single-centre study, including patients diagnosed with spontaneous coronary artery dissection (n=60) admitted between January 2010 and December 2020. Results: Median age was 55 years, and 83% were women. Most patients (60%) presented without any or just one cardiovascular risk factor. Non-ST-segment elevation acute myocardial infarction accounted for 67% of clinical presentations. The most frequently affected coronary artery was the left anterior descending (47%). Most lesions (77%) appeared on angiography as type 2 spontaneous coronary artery dissection. Conservative management was chosen as the initial approach in most patients (72%). The overall incidence of de novo spontaneous coronary artery dissection was not significantly different among patients initially managed with revascularization as compared to conservative treatment (p=0.953). However, spontaneous coronary artery dissection recurrence occurred in the originally involved vessel in 3 of 15 patients initially managed with revascularization, as compared to only one among 43 patients treated conservatively (p<0.05). Conclusion: Spontaneous coronary artery dissection occurs more often in young women. Non- ST-segment elevation acute myocardial infarction was the most frequent clinical presentation involving mainly the left anterior descending artery. Revascularization did not protect from recurrence.

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Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Oliveira¹,

Vasconcelos²,

Abreu³

et al. 2023

J Transcat Intervent

View full text Add to dashboard Cite

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“…OCT proved to be able to identify the rupture site (the entry tear), visualise the intimo-medial membrane and comprehensively assess the characteristics, extent and distribution of the true and false lumen/IMH.The technique could also be used to disclose the involvement of related side branches and the presence of thrombus in the false or the true lumen. Other studies have confirmed the utility of OCT as a diagnostic tool as well as for guiding PCI [61][62][63][64]. Jackson et al described unique OCT findings in a larger series of 65 SCAD patients.…”

mentioning

confidence: 88%

Spontaneous Coronary Artery Dissection: Mechanisms, Diagnosis and Management

et al. 2020

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Spontaneous coronary artery dissection (SCAD) is a relatively infrequent cause of acute coronary syndrome that usually affects young to middle-aged women. Mainly because of its low prevalence, until recently, most of the evidence on this condition was derived from case reports and small series. Over the last 5 years, more robust evidence has become available from larger retrospective and prospective cohorts of patients with SCAD. The increase in knowledge and recognition of this entity has led to the publication of expert consensus on both sides of the Atlantic. However, new data are continuously accumulating from larger cohorts of patients with SCAD, bringing new light to this little-understood condition. The aim of this article is to update the knowledge on SCAD, including new information from recent studies published since the consensus documents from the European Society of Cardiology and the American Heart Association.

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OCT Imaging of SCAD and Differential Diagnosis

Parsa

Saw

2019

Cardiovascular OCT Imaging

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Optical Coherence Tomography–Guided Full Plastic Jacket in Spontaneous Coronary Artery Dissection

Abstract: A healthy 38-year-old woman was hospitalized for an acute coronary syndrome. Coronary angiography revealed a smooth, diffusely narrowed right coronary artery ( Figure 1A). With an adequate level of suspicion, optical coherence tomography (OCT) was performed and identified sponta-

Cited by 7 publications

References 1 publication

Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Spontaneous Coronary Artery Dissection: Mechanisms, Diagnosis and Management

OCT Imaging of SCAD and Differential Diagnosis

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