Role of Invasive and Non-invasive Imaging Tools in the Diagnosis and Optimal Treatment of Patients with Spontaneous Coronary Artery Dissection

Journal Article · Tue Oct 15 00:00:00 EDT 2019 · Current Cardiology Reports (Print)

DOI:https://doi.org/10.1007/S11886-019-1202-0· OSTI ID:22929167

Cerrato, Enrico ^[1]; Giacobbe, Federico ^[2]; Rolfo, Cristina; Quadri, Giorgio; Tomassini, Francesco; Ferrari, Fabio; Mariani, Fabio ^[1]; Anselmino, Matteo ^[2]; Bianco, Matteo ^[3]; Belliggiano, Davide ^[2]; Franzé, Alfonso ^[4]; Barbero, Umberto ^[5]; Porto, Italo ^[6]; others, and

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1. San Luigi Gonzaga University Hospital, Interventional Cardiology Unit, Orbassano, and Infermi Hospital (Italy)
2. University of Turin, Division of Cardiology, “Città della Salute e della Scienza di Torino” Hospital, Department of Medical Sciences (Italy)
3. San Luigi Gonzaga University Hospital, Department of Cardiology (Italy)
4. Infermi Hospital, Cardiology Division (Italy)
5. Santissima Annunziata Hospital, Cardiology Division (Italy)
6. University of Genoa, Interventional Cardiology Unit, San Martino Hospital (Italy)

Purpose of Review: Spontaneous coronary artery dissection (SCAD) is a serious non-atherosclerotic disease, most frequently presenting as an acute coronary syndrome and affecting female patients. Considering that diagnosis of SCAD is often elusive, and its interventional treatment is associated to a higher rate of complications than obstructive atherosclerotic disease, we aim to review all the imaging tools currently available for the optimal diagnosis and treatment of this condition. Recent Findings: The developments in both invasive and non-invasive imaging alternatives to coronary angiography, such as intravascular ultrasound, optical coherence tomography, and computed coronary angiography, have largely contributed to appraise the epidemiology of SCAD, understand its causative pathophysiological mechanisms, and improve our ability to confirm doubtful cases of SCAD. Intracoronary imaging is also a valuable in deciding the best therapeutic approach and in guiding interventions in those patients requiring percutaneous treatment. Furthermore, non-invasive imaging is a key tool in ruling out significant extracoronary vascular abnormalities which frequently occur in patients with underlying conditions like fibromuscular dysplasia who develop SCAD. Summary: Main imaging tools employed in SCAD cases could have advantages and drawbacks. Focusing on different types of SCAD, operators should be able to choose the best imaging technique for diagnosis, management, and follow-up.

• OSTI ID: 22929167
• Journal Information: Current Cardiology Reports (Print), Vol. 21, Issue 10; Other Information: Copyright (c) 2019 Springer Science+Business Media, LLC, part of Springer Nature; http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA); ISSN 1523-3782
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOMEDICAL RADIOGRAPHY
CORONARIES
DIAGNOSIS
DISEASES
EPIDEMIOLOGY
PATIENTS
TOMOGRAPHY