Spontaneous coronary artery dissection

Currently, the clinical recognition of SCAD has increased as coronary angiography is utilised frequently in the clinical evaluation of patients with acute coronary syndromes. [...]intracoronary imaging techniques such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), which provide detailed morphological information on coronary lesions and on the location of dissection planes between the different layers of the arterial wall, have enabled a more detailed clinical assessment of SCAD. 3 More recently the syndrome has become increasingly diagnosed, as coronary angiography is more often performed in patients suspected of having an acute coronary syndrome. 4 The incidence of SCAD in angiographic series varies widely-from 0.07% up to 1.1% for patients who are referred for coronary angiography. 5-11 Studies Study population Number of cases Incidence (%) Initial treatment, N (%) Mean follow-up (months) De Maio et al 3 - 27 - - - - 2 (7.0) 41 96 Pasalados Pita et al 5 2241 5 0.22 3 (60) 0 (0) 2 (40) 0 (0.0) 18 100 Jorgensen et al 6 9852 10 0.10 6 (60) 0 (0) 4 (40) 0 (0.0) 21 90 Zampieri et al 7 2225 5 0.22 5 (100) 0 (0) 0 (0) 0 (0.0) 27 80 Hering et al 8 3803 42 1.10 3 (7) 31 (14) 8 (19) 1 (2.0) 13.5 76 Celik et al 9 3750 9 0.24 1 (11) 1 (11) 7 (11) 0 (0.0) 12 89 Valnetto et al 10 11605 23 0.20 10 (44) 8 (34) 5 (22) 1 (4.0) 15.6 77 Mortensen et al 11 32869 22 0.0007 7 (32) 13 (59) 2 (9) 0 (0.0) 34.8 100 CABG, coronary artery bypass surgery; PCI, percutaneous coronary intervention.