Best Practices for Women with Spontaneous Coronary Artery Dissection Undergoing Invasive Coronary Angiography

Interv Cardiol Clin. 2025 Jan;14(1):49-67. doi: 10.1016/j.iccl.2024.08.002.

Abstract

Spontaneous coronary artery dissection (SCAD) is a pathophysiologically heterogenous, infrequent but high-risk cause of acute coronary syndrome in a young, unsuspecting population without traditional cardiovascular risk factors. Diagnosis requires a high index of clinical suspicion, knowledge of the angiographic features of SCAD, and comfort with using the necessary ancillary diagnostic tools. Although most of the patients are medically managed, a small percentage do require revascularization. Knowing the high risk of complications and failure rate associated with SCAD percutaneous coronary intervention, interventional cardiologists should familiarize themselves with the recommended strategies and best practices to maximize success and improve patient outcomes.

Keywords: Intravascular imaging; Percutaneous techniques; Revascularization; Spontaneous coronary artery dissection.

Publication types

  • Review

MeSH terms

  • Coronary Angiography* / methods
  • Coronary Vessel Anomalies* / diagnosis
  • Coronary Vessel Anomalies* / diagnostic imaging
  • Coronary Vessel Anomalies* / surgery
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery
  • Female
  • Humans
  • Percutaneous Coronary Intervention* / methods
  • Practice Guidelines as Topic
  • Risk Factors
  • Vascular Diseases / congenital
  • Vascular Diseases / diagnosis
  • Vascular Diseases / surgery

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous