IVUS and OCT guided primary percutaneous coronary intervention for spontaneous coronary artery dissection with bioresorbable vascular scaffolds
IVUS and OCT guided primary percutaneous coronary intervention for spontaneous coronary artery dissection with bioresorbable vascular scaffolds
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DOI：
10.1016/j.carrev.2016.09.005
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发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Austin, David
中科院分区：
文献类型：
--
作者：
Mahmood, Muhammad Muzaffar;Austin, David
自发性冠状动脉夹层（SCAD）是急性冠状动脉综合征的一种罕见但重要的原因。通过angiogramalone诊断SCAD可能具有挑战性，冠状动脉内成像的使用越来越多，已证明在这方面是一种非常宝贵的诊断辅助手段。SCAD的适当初始管理一直是一个重要的辩论问题。由于冠状动脉夹层的频繁自发愈合以及SCAD背景下经皮冠状动脉介入治疗（PCI）并发症的风险较高，因此不建议采用机械血运重建的默认方法。然而，在存在血管闭塞和正在进行的心肌梗死的情况下，必须进行PCI。在SCAD环境中，生物可吸收血管支架（BVS）比传统支架具有潜在优势。我们描述了一种利用血管内超声（IVUS）、光学相干断层扫描（OCT）和BVS急性治疗引起STEMI的SCAD的最先进方法，并讨论了现代的管理策略。(C)2016 Elsevier Inc. All rights reserved.
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogramalone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initialmanagement of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended. However in the presence of vessel occlusion and on-going myocardial infarction PCI is mandated. Bioresorbable vascular scaffolds (BVS) offer potential advantages over the conventional stents in the setting of SCAD. We describe a state-of-the-art approach to the acute treatment of SCAD causing STEMI, utilizing intravascular ultrasound (IVUS), optical coherence tomography (OCT) and BVS and discuss management strategies for the modern era. (C) 2016 Elsevier Inc. All rights reserved.