Friable coronary arteries are link between pathogenesis and treatment of spontaneous coronary artery dissection.

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Acta Clinica Belgica Pub Date : 2014-06-01 Epub Date: 2014-04-08 DOI:10.1179/2295333714Y.0000000020
M Vanhaverbeke, T Sarens, L Van Driessche
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引用次数: 1

Abstract

Abstract Spontaneous coronary artery dissection (SCAD) is increasingly being diagnosed as the cause of an acute coronary syndrome, especially in young patients. We report the case of a 32-year-old woman with postpartum SCAD of the left main and left anterior descending coronary artery which required the implantation of two drug-eluting stents. We present a literature study that correlates the pathogenesis of SCAD to the treatment options. Non-atherosclerotic SCAD is clearly associated with connective tissue disorders, vasculitis, and the peripartum period with its hormonal and haemodynamic changes. The coronary arteries of these SCAD patients are friable and should be approached with caution. Percutaneous coronary intervention has a reported success rate of only 65% and may cause propagation of the dissection. Lately, more and more authors suggest the possibility of a conservative approach in the absence of remaining cardiac ischaemia, even in this era of percutaneous stent implantation.
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冠状动脉脆弱是自发性冠状动脉夹层发病和治疗的重要环节。
自发性冠状动脉剥离(SCAD)越来越多地被诊断为急性冠状动脉综合征的原因,特别是在年轻患者中。我们报告的情况下,32岁的妇女产后SCAD左主干和左前降支需要植入两个药物洗脱支架。我们提出了一项文献研究,将SCAD的发病机制与治疗方案联系起来。非动脉粥样硬化性SCAD与结缔组织疾病、血管炎和围产期激素和血流动力学变化明显相关。这些SCAD患者的冠状动脉是脆弱的,应谨慎处理。据报道,经皮冠状动脉介入治疗的成功率仅为65%,并可能导致夹层扩大。最近,越来越多的作者提出,即使在这个经皮支架植入的时代,在没有剩余心脏缺血的情况下,保守方法的可能性。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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