Presenter
Simone Zecchino, Ospedale degli Infermi, Rivoli, San Mauro Torinese, Torino, Italy
Simone Zecchino, Ospedale degli Infermi, Rivoli, San Mauro Torinese, Torino, Italy
Keywords: Hemodynamic Support, Imaging & Physiology and Left Main and Bifurcation
Title SCAD Introduction While being a relatively rare condition, Spontaneous coronary artery dissection (SCAD) is an eventuality that must always be considered when evaluating clinical presentations, since the implications are potentially catastrophic. We recently encountered a case involving a 62-year-old woman with clinical presentation suggestive of SCAD: given the importance of understanding coronary anatomy in the diagnostic and therapeutic algorithm in such cases, we performed coronary angiography. Clinical Case Upon the first injection of dye into the Left Main (LM), an extensive dissection involving both Left Anterior Descending (LAD) and Circumflex (Cx) occurred, leading to hemodynamic instability: to address this situation, we employed various techniques to gain the true lumen of both vessels and took advantage of the use of hemodynamic support with Intra-aortic Balloon Pump (IABP). Once hemodynamic stability was achieved, we proceeded with an extensive Intravascular Ultrasound (IVUS) - guided stenting, ultimately achieving an excellent final angiographic result. The patient was discharged in excellent condition and with preserved left ventricular function. Discussion Managing iatrogenic complications in patients with SCAD is a very sensitive topic, particularly for less experienced operators. The review of cases such as this one can contribute to the prevention of certain scenarios and guide the right course of action when they cannot be avoided.