22 1 SCAD: Manual of PCI

How to perform coronary angiography and PCI in patients with spontaneous coronary artery dissection.

[@doctorss5]

Thank you so much for your valuable work

[@areenal-taie6836]

Thanks a lot, Great one !

[@svijaykumarreddy1242]

Excellent.

[@user-su4he3ju7t]

Hello, professor Emmanouil Brilakis. Thank You for this presentation. What You think about stent implantation near distal part of hematoma and little bit proximal of this i.e. to performe "hematoma trapping", and than performe cutting balloon and stent implantation in place of hematoma, creating little stent overlaping? I have SCAD case in my practice.It was anterior STEMI and LAD was occluded in mid part. Stent implantation in mid LAD segment cause leading hematoma more proximally in ostium of LAD and large intermedial branch. After stenting of LAD ostium, LCx ostium compromitation was occured with 90% lumen loss, and intermedial branch was occluded. A trifurcation stenting was done, but intermedial branch was occluded in distal part. LAD and LCx was patent. SCAD is life threatening situation in some cases. It was one vessel dissection, but after first stenting it was two vessel hematoma. Thank You for all You doing for us.

[@manosbrilakis]

Excellent point, thank you very much!!

[@shaveenvijayan8423]

Sir, is it possible to differentiate type 2 and 3 scad from atherosclerotic changes by angiography alone?? Especially if its not a young female post partum. btw very useful videos sir.

[@manosbrilakis]

Agree this is very hard to do without intravascular imaging.