Premium
Coronary artery fenestration as rescue management of intramural haematoma with luminal compression
Author(s) -
Bresson Didier,
Calcaianu Mihaela,
Lawson Bree,
Jacquemin Laurent
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28186
Subject(s) - medicine , percutaneous coronary intervention , cardiology , myocardial infarction , fractional flow reserve , thrombolysis , angioplasty , radiology , revascularization , decompression , surgery , coronary angiography
Conservative management is the first‐line treatment for spontaneous coronary artery dissection (SCAD) with stable haemodynamic status and thrombolysis in myocardial infarction three flow on angiography. However, in a few very specific patients, recurrent ischemia, or haemodynamic instability necessitates revascularization. Here, we describe a case of successful optical coherence tomography (OCT)‐guided percutaneous coronary intervention (PCI) with a cutting balloon. We performed fenestration at multiple decompression sites prior to stenting in an intramural haematoma with luminal compression. Rescue management of SCAD with luminal compression is a critical issue, because SCAD is an emergent clinical condition affecting young patients with a severe prognosis. To our knowledge, there are no large published series evaluating procedural success rates and long‐term follow‐up of this technique.