Coronary angioplasty in spontaneous coronary artery dissection—Strategy and outcomes

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dc.contributor.authorValappil, Sanjai Pattuen_US
dc.contributor.authorIype, Mathewen_US
dc.contributor.authorViswanathan, Sunithaen_US
dc.contributor.authorKoshy, Alummoottil Georgeen_US
dc.contributor.authorGupta, Prabha Ninien_US
dc.contributor.authorVelayudhan, Radhakrishnan Vellikatuen_US
dc.date.accessioned2020-01-02T06:40:13Z
dc.date.available2020-01-02T06:40:13Z
dc.date.issued2018-11
dc.description.abstractObjective To study the clinical, angiographic and technical characteristics of patients with spontaneous coronary artery dissection (SCAD) undergoing percutaneous coronary intervention (PCI). Methods This was a retrospective single center study where patients with angiographically confirmed SCAD undergoing PCI over a period of 4 years (2013–2017) were analyzed. We also sought to identify the clinical and angiographic predictors of procedural failure during PCI. Results There were a total of 42 patients with angiographically confirmed SCAD during the study period of which 16 patients (38.1%) underwent PCI. 14 out of the 16 patients (87.5%) taken up for PCI had technical success. In all patients the lesion was initially attempted to cross with a floppy wire and if unsuccessful it was escalated to a hydrophilic wire and finally to a stiff wire The SCAD lesion was crossed with a floppy wire in 71.4% of patients, with a hydrophilic wire in 14.2% and a stiff wire in 7.1% of patients. Wire escalation was required in 5 patients (31.3%) and in 60% of cases there was a technical success after wire escalation. Presence of diabetes mellitus, hypertension, dyslipidemia, smoking, coexisting atherosclerosis, diffuse nature of the lesion, and baseline Thrombolysis in Myocardial Infarction (TIMI) ≤ 2 flow did not predict procedural failure during PCI. Conclusion PCI in SCAD is associated with a fair rate of technical success in our population. Choosing an initial floppy wire and then escalating to a hydrophilic wire followed by a stiff wire is an optimal revascularization strategy.en_US
dc.identifier.affiliationsDepartment of Cardiology, Government Medical College, Thiruvananthapuram, Kerala, 695011, Indiaen_US
dc.identifier.citationValappil Sanjai Pattu, Iype Mathew, Viswanathan Sunitha, Koshy Alummoottil George, Gupta Prabha Nini, Velayudhan Radhakrishnan Vellikatu. Coronary angioplasty in spontaneous coronary artery dissection—Strategy and outcomes. Indian Heart Journal. 2018 Nov; 70(6): 843-847en_US
dc.identifier.issn0019-4832
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/191629
dc.languageenen_US
dc.publisherCardiological Society of Indiaen_US
dc.relation.issuenumber6en_US
dc.relation.volume70en_US
dc.source.urihttps://doi.org/10.1016/j.ihj.2018.01.004en_US
dc.subjectSpontaneous coronary artery dissectionen_US
dc.subjectPercutaneous coronary interventionen_US
dc.subjectAcute coronary syndromeen_US
dc.subjectCoronary guidewireen_US
dc.titleCoronary angioplasty in spontaneous coronary artery dissection—Strategy and outcomesen_US
dc.typeJournal Articleen_US
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