The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection
Spontaneous coronary artery dissection (SCAD) is a non-traumatic, non-atherosclerotic layering of the coronary artery wall due to the presence of a subintimal hematoma or an intimal tear with the creation of a false lumen that compresses the true lumen and restricts or obstructs the flow. Patients w...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-08-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/24/8/10.31083/j.rcm2408235 |
| _version_ | 1797733169982603264 |
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| author | Svetlana Apostolovic Bojan Maricic Nenad Bozinovic Tomislav Kostic Zoran Perisic Aleksandra Djokovic Mihajlo Bojanovic Milovan Petrovic Goran Stankovic |
| author_facet | Svetlana Apostolovic Bojan Maricic Nenad Bozinovic Tomislav Kostic Zoran Perisic Aleksandra Djokovic Mihajlo Bojanovic Milovan Petrovic Goran Stankovic |
| author_sort | Svetlana Apostolovic |
| collection | DOAJ |
| description | Spontaneous coronary artery dissection (SCAD) is a non-traumatic, non-atherosclerotic layering of the coronary artery wall due to the presence of a subintimal hematoma or an intimal tear with the creation of a false lumen that compresses the true lumen and restricts or obstructs the flow. Patients with SCAD and preserved coronary flow are treated conservatively according to the general recommendations. However, percutaneous coronary intervention should be considered in patients with artery occlusion and/or refractory ischemia. Stenting is associated with increased risks comprising stenting in the false lumen, in-stent thrombosis, and/or stent malappositon as well as antegrade or retrograde propagation of the intramural hematoma. Intracoronary imaging is of great value both for the diagnosis and treatment of SCAD. There is rising scrutiny on the use of cutting balloons in acute coronary syndrome caused by SCAD. The idea of using cutting balloons is to fenestrate the intima and drain the intramural hematoma. Our review presents an analysis of 17 published cases of cutting balloon (CB) use in SCAD. What is encouraging is that of the 12 published cases, in 11 Thrombolysis in Myocardial Infarction (TIMI) 3 flow was established with this technique, and TIMI 2 flow in one, without subsequent stent implantation. Four patients received a stent after the CB use, while one patient underwent CB angioplasty after hematoma propagation caused by stent implantation. In all cases, patients were asymptomatic at follow-up, with TIMI 3 flow. |
| first_indexed | 2024-03-12T12:25:16Z |
| format | Article |
| id | doaj.art-f649fc0a8f9243ba9401d21a21b2e3ea |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-12T12:25:16Z |
| publishDate | 2023-08-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-f649fc0a8f9243ba9401d21a21b2e3ea2023-08-30T02:44:47ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-08-0124823510.31083/j.rcm2408235S1530-6550(23)00996-1The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery DissectionSvetlana Apostolovic0Bojan Maricic1Nenad Bozinovic2Tomislav Kostic3Zoran Perisic4Aleksandra Djokovic5Mihajlo Bojanovic6Milovan Petrovic7Goran Stankovic8Department of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Hospital Center Bezanijska kosa, 11080 Belgrade, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, University Clinical Center Nis, 18000 Nis, SerbiaDepartment of Cardiology, Division of Interventional Cardiology, Cardiovascular Institute Vojvodina, 21204 Sremska Kamenica, SerbiaFaculty of Medicine, Department of Internal Medicine, University of Belgrade, 11000 Belgrade, SerbiaSpontaneous coronary artery dissection (SCAD) is a non-traumatic, non-atherosclerotic layering of the coronary artery wall due to the presence of a subintimal hematoma or an intimal tear with the creation of a false lumen that compresses the true lumen and restricts or obstructs the flow. Patients with SCAD and preserved coronary flow are treated conservatively according to the general recommendations. However, percutaneous coronary intervention should be considered in patients with artery occlusion and/or refractory ischemia. Stenting is associated with increased risks comprising stenting in the false lumen, in-stent thrombosis, and/or stent malappositon as well as antegrade or retrograde propagation of the intramural hematoma. Intracoronary imaging is of great value both for the diagnosis and treatment of SCAD. There is rising scrutiny on the use of cutting balloons in acute coronary syndrome caused by SCAD. The idea of using cutting balloons is to fenestrate the intima and drain the intramural hematoma. Our review presents an analysis of 17 published cases of cutting balloon (CB) use in SCAD. What is encouraging is that of the 12 published cases, in 11 Thrombolysis in Myocardial Infarction (TIMI) 3 flow was established with this technique, and TIMI 2 flow in one, without subsequent stent implantation. Four patients received a stent after the CB use, while one patient underwent CB angioplasty after hematoma propagation caused by stent implantation. In all cases, patients were asymptomatic at follow-up, with TIMI 3 flow.https://www.imrpress.com/journal/RCM/24/8/10.31083/j.rcm2408235spontaneous coronary artery dissectioncutting balloonacute coronary syndrome |
| spellingShingle | Svetlana Apostolovic Bojan Maricic Nenad Bozinovic Tomislav Kostic Zoran Perisic Aleksandra Djokovic Mihajlo Bojanovic Milovan Petrovic Goran Stankovic The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection Reviews in Cardiovascular Medicine spontaneous coronary artery dissection cutting balloon acute coronary syndrome |
| title | The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection |
| title_full | The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection |
| title_fullStr | The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection |
| title_full_unstemmed | The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection |
| title_short | The Use of Cutting Balloons in Published Cases of Acute Coronary Syndrome Caused by Spontaneous Coronary Artery Dissection |
| title_sort | use of cutting balloons in published cases of acute coronary syndrome caused by spontaneous coronary artery dissection |
| topic | spontaneous coronary artery dissection cutting balloon acute coronary syndrome |
| url | https://www.imrpress.com/journal/RCM/24/8/10.31083/j.rcm2408235 |
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