title: Spontaneous coronary artery dissection in a middle-age woman: percutaneous treatment guided by intracoronary imaging techniques.
abstract: : Angiographic diagnosis and treatment of spontaneous coronary artery dissection is challenging. Complementary use of intracoronary imaging can provide information to guide percutaneous treatments, particularly in these challenging settings. Here we report a case of a 52-year-old woman presenting with an anterior ST-segment elevation myocardial infarction caused by a spontaneous, long, and spiral dissection of the left anterior descending artery. Intracoronary imaging allowed us to visualize the entry port of the coronary dissection which was not sealed by the first angio-guided stenting. This case demonstrates that, beyond merely diagnostic information, the intracoronary imaging is able to provide information to guide percutaneous treatments, particularly in challenging settings in which coronary angiography reveals its limitations.
authors.affiliation: aDepartment of Cardiovascular Diseases, University Hospital Santa Maria alle Scotte, Siena, Italy *Massimo Fineschi and Flavio D'Ascenzi contributed equally to the writing of this article.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fineschi
authors.forename: Flavio
authors.initials: F
authors.lastname: D'Ascenzi
authors.forename: Vasile
authors.initials: V
authors.lastname: Sirbu
authors.forename: Sergio
authors.initials: S
authors.lastname: Mondillo
authors.forename: Carlo
authors.initials: C
authors.lastname: Pierli
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014652:Vascular Diseases / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000628:therapy