Key result
Invasive intravascular imaging modalities such as OCT and IVUS facilitate accurate diagnosis of spontaneous coronary artery dissection in angiographically ambiguous cases.
Why the study?
SCAD is often misdiagnosed due to the absence of angiographic hallmarks, making accurate diagnosis through meticulous angiography and intravascular imaging crucial because optimal management differs from atherosclerotic disease.
Intravascular imaging modalities such as OCT and IVUS are crucial for accurately diagnosing spontaneous coronary artery dissection in angiographically ambiguous cases, thereby guiding appropriate management.
Supports OCT/IVUS for ambiguous SCAD diagnosis; leaves open prospective outcome trials before routine use.
Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome (ACS) with recent advancements in cardiac imaging facilitating its identification. However, SCAD is still often misdiagnosed due to the absence of angiographic hallmarks in a significant number of cases, highlighting the importance of meticulous interpretation of angiographic findings and, when necessary, additional usage of intravascular imaging to verify changes in arterial wall integrity and identify specific pathoanatomical features associated with SCAD. Accurate diagnosis of SCAD is crucial, as the optimal management strategies for patients with SCAD differ from those with atherosclerotic coronary disease. Current treatment strategies favor a conservative approach, wherein intervention is reserved for cases with persistent ischemia, patients with high-risk coronary anatomy, or patients with hemodynamic instability. In this paper, we provide a preview of invasive imaging modalities and classical angiographic and intravascular imaging hallmarks that may facilitate proper SCAD diagnosis.
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Mehmedbegović et al. (2023) conducted a review in Spontaneous coronary artery dissection (SCAD). Invasive imaging modalities (OCT, IVUS) was evaluated. Invasive intravascular imaging modalities such as OCT and IVUS facilitate accurate diagnosis of spontaneous coronary artery dissection in angiographically ambiguous cases.