Marco Lombardi, Jorge Chavez-Solsol, Pablo Salinas, Enrico Cerrato, Rocco Vergallo, Italo Porto, Ferdinando Varbella, Nieves Gonzalo, Javier Escaned, Fernando Macaya-Ten
{"title":"The role of percutaneous coronary intervention in spontaneous coronary artery dissection: between Scylla and Charybdis.","authors":"Marco Lombardi, Jorge Chavez-Solsol, Pablo Salinas, Enrico Cerrato, Rocco Vergallo, Italo Porto, Ferdinando Varbella, Nieves Gonzalo, Javier Escaned, Fernando Macaya-Ten","doi":"10.23736/S2724-5683.24.06680-8","DOIUrl":null,"url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a distinct and increasingly recognized cause of acute coronary syndromes, primarily affecting young and middle-aged women with few cardiovascular risk factors. While SCAD often resolves spontaneously with conservative management, percutaneous coronary intervention (PCI) is sometimes necessary, especially in patients with ongoing ischemia or high-risk anatomical features. This review summarizes the current state of knowledge regarding the interventional approach in SCAD, emphasizing the rationale for conservative treatment, and the indications for and challenges associated with PCI. It also provides practical recommendations, particularly highlighting technical aspects of PCI in SCAD, the critical role of intracoronary imaging, and the modality and timing of post-PCI surveillance.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva cardiology and angiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S2724-5683.24.06680-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Spontaneous coronary artery dissection (SCAD) is a distinct and increasingly recognized cause of acute coronary syndromes, primarily affecting young and middle-aged women with few cardiovascular risk factors. While SCAD often resolves spontaneously with conservative management, percutaneous coronary intervention (PCI) is sometimes necessary, especially in patients with ongoing ischemia or high-risk anatomical features. This review summarizes the current state of knowledge regarding the interventional approach in SCAD, emphasizing the rationale for conservative treatment, and the indications for and challenges associated with PCI. It also provides practical recommendations, particularly highlighting technical aspects of PCI in SCAD, the critical role of intracoronary imaging, and the modality and timing of post-PCI surveillance.