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Published on: July 9, 2020
An analysis of published cases of cutting balloon use in spontaneous coronary artery dissection
Bojan Maričić1, Zoran Perišić1,2, Tomislav Kostić1,2
1Department of Cardiology, University Clinical Center Nis, Niš, Serbia.
Insights
Cutting balloon angioplasty shows favorable outcomes for spontaneous coronary artery dissection (SCAD). This analysis of 32 cases indicates a safe and effective treatment option for SCAD patients.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Spontaneous coronary artery dissection (SCAD) is a condition involving a tear in the coronary artery wall, leading to myocardial ischemia.
- SCAD predominantly affects younger females without traditional cardiovascular risk factors.
Purpose of the Study:
- To evaluate the efficacy and outcomes of using cutting balloons in patients with spontaneous coronary artery dissection.
- To analyze published cases of cutting balloon intervention for SCAD.
Main Methods:
- A systematic literature search was performed across major databases (PubMed, MEDLINE, Embase, Cochrane, Google Scholar).
- Keywords included "cutting balloon," "SCAD," "acute coronary syndrome," "intramural hematoma," and "angioplasty."
- 32 published cases of cutting balloon use in SCAD were analyzed.
Main Results:
- The majority of SCAD patients treated with cutting balloons were female, with a median age of 46.
- The Left Anterior Descending artery was most commonly affected.
- Distal hematoma propagation was the most frequent complication, with some cases requiring stenting.
Conclusions:
- Cutting balloon intervention in SCAD cases demonstrates favorable outcomes.
- This technique can be a viable option for managing spontaneous coronary artery dissection.
Introduction:
SCAD involves a sudden tear or separation within the layers of the coronary artery wall, resulting in blood flow obstruction and subsequent myocardial ischemia.
Materials And Methods:
A comprehensive literature search was conducted to identify relevant published cases of cutting balloon use in patients diagnosed with spontaneous coronary artery dissection. Electronic databases including PubMed, MEDLINE, Embase, Cochrane Library and Google Scholar were systematically searched from inception until the present using terms "cutting balloon," "SCAD," "acute coronary syndrome," "intramural hematoma," and "angioplasty."
Results:
A total of 32 published cases of cutting balloon use in spontaneous coronary artery dissection were analyzed in this study. The majority of the patients included in the analysis were female without prior history of cardiovascular disease. The median age of the SCAD population was approximately 46 years. The most frequently affected artery in SCAD cases was the Left Anterior Descending artery. Intravascular ultrasound was utilized more frequently than other modalities of adjunctive imaging techniques. The most frequent complication was the distal propagation of hematoma. Despite the successful dilation achieved with the cutting balloon, in some cases stenting was required to provide additional support.
Conclusion:
The results of this analysis demonstrate that cutting balloon use in SCAD cases yields favorable outcomes.
