Intravascular ultrasound identified an extensive coronary dissection, and subsequent PTCA improved coronary flow reserve and stabilized the patient's angina.
Case Report (n=1)
Can intravascular ultrasound effectively assess spontaneous coronary artery dissection and guide PTCA in a patient with unstable angina?
Intravascular ultrasound is a valuable tool for clarifying ambiguous angiographic findings in spontaneous coronary artery dissection and can help guide successful percutaneous intervention.
We describe a case of spontaneous coronary artery dissection that gave rise to post infarction unstable angina. An ambiguous angiographic appearance was shown by intracoronary ultrasound to arise from an extensive coronary dissection. The dissection membrane separating true and false lumina and features to suggest sluggish flow and early thrombosis in the false lumen were observed. No increase in lumen calibre was evident on ultrasound after PTCA (probably a consequence of the relatively large ultrasound catheter blank), but coronary flow reserve measured with intracoronary Doppler did improve and the patient remained stable and free of angina following the procedure.
Kearney et al. (Sun,) conducted a case report in Spontaneous coronary artery dissection with unstable angina (n=1). Intravascular ultrasound and PTCA was evaluated on Coronary flow reserve and angina status. Intravascular ultrasound identified an extensive coronary dissection, and subsequent PTCA improved coronary flow reserve and stabilized the patient's angina.