scholarly journals Cutting balloon angioplasty for treatment of spontaneous coronary artery dissection: case report, literature review, and recommended technical approaches

2019 ◽  
Vol 9 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Anthony Main ◽  
William L. Lombardi ◽  
Jacqueline Saw
Author(s):  
Hiroshi Fujita ◽  
Masashi Yokoi ◽  
Tsuyoshi Ito ◽  
Takafumi Nakayama ◽  
Yasuhiro Shintani ◽  
...  

Abstract Background Spontaneous coronary artery dissection (SCAD) is a unique cause of myocardial infarction, and optimal treatment should be selected according to the ischaemic condition. Patients with ongoing ischaemia or haemodynamic instability may require revascularization. Cutting balloon angioplasty has been acknowledged as an option for revascularization. However, few observations of the coronary artery conditions after cutting balloon angioplasty in SCAD patients have been reported. Here, we demonstrate two cases in which we evaluated the angiographic morphology of targeted coronary arteries in the chronic phase after cutting balloon angioplasty. Case summary Patient 1 was a 46-year-old woman who presented at our hospital with chest pain. Electrocardiography suggested acute coronary syndrome and coronary angiography was performed. The coronary angiography and intravascular ultrasound (IVUS) examinations revealed SCAD in the left anterior descending artery (LAD). Revascularization with cutting balloon angioplasty was successful. Follow-up coronary angiography 15 months after the angioplasty showed no visible stenosis in the LAD. Accordingly, the patient no longer needed to antiplatelet therapy. Patient 2 was a 50-year-old woman who was transported to our hospital for ventricular tachycardia. Coronary angiography and IVUS revealed SCAD in the right coronary artery. Coronary flow was restored by cutting balloon angioplasty. Follow-up contrast-enhanced computed tomography angiography 36 months after angioplasty showed a healed appearance. Thus, she was able to discontinue antiplatelet therapy. Conclusion Cutting balloon angioplasty may be a possible method to treat SCAD.


Cureus ◽  
2021 ◽  
Author(s):  
Esiemoghie J Akhigbe ◽  
Ebubechukwu Ezeh ◽  
Kanaan Mansoor ◽  
Jason Mader ◽  
Paul I Okhumale ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Jessica O’Neil ◽  
Soumyaa Mazumder ◽  
Danita Yoerger Sanborn ◽  
Samantha Wu

There are a variety of cardiac complications of anorexia nervosa including arrythmias, valvopathies, and myopathies. Spontaneous coronary artery dissection (SCAD) has not been widely reported among this patient population. This case report describes a middle-aged female with severe anorexia nervosa, who presented after being found unconscious, and was later diagnosed with SCAD. A literature review revealed one previous case of SCAD in a patient with anorexia nervosa and prompted a discussion of a series of possible predisposing factors for SCAD in this patient population. Patients with anorexia nervosa may be at increased risk for SCAD due to their complex nutritional and endocrine imbalances. This case highlights a possible underdiagnosed cardiac complication of anorexia nervosa.


Author(s):  
Shintaro Matsuura ◽  
Kanichi Otowa ◽  
Michiro Maruyama ◽  
Kazuo Usuda

We present a case of successful revascularization for spontaneous coronary artery dissection (SCAD) using coronary artery fenestration followed by the subintimal transcatheter withdrawal (STRAW) technique. The combination of the STRAW technique and coronary artery fenestration with cutting balloon angioplasty could be a new treatment option for SCAD patients requiring revascularization.


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