Case Report
 
Spontaneous coronary artery dissection treated with biovascular scaffolds: Old riddle, novel approach
Chinyere C. Iwuala
Internal Medicine Department, Dalhousie University, Saint John Site, No. 400 University Avenue NB E2L 4L4, Canada.

Article ID: Z01201611CR10711CI
doi:10.5348/ijcri-2016123-CR-10711

Address correspondence to:
Dr. Chinyere C. Iwuala
(MBBS); Internal Medicine Department, Dalhousie University, Saint John Site
No. 400 University Avenue NB E2L 4L4
Canada

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How to cite this article
Iwuala CC. Spontaneous coronary artery dissection (SCAD) treated with biovascular scaffolds: Old riddle, novel approach. Int J Case Rep Images 2016;7(11):710–713.


Abstract
Introduction: Spontaneous coronary artery dissection (SCAD) is a rare, poorly understood disease (incidence 0.1–1.1%). Management modalities vary and are mostly based on consensus from relatively some study results. Percutaneous intervention (PCI) with conventional drug eluting stents (DES), though acceptable treatment for complicated cases, has a widely variable rate of success (65–90%), hence the search for alternative solutions.
Case Report: We present the case of a premenopausal female with no known cardiac risk factor, admitted with a non-ST elevation myocardial infarction (NSTEMI), who, on cardiac angiogram, was found to have had a spontaneous coronary artery dissection (SCAD). Conservative management is the consensus treatment for uncomplicated cases, but failed in this case. Biovascular scaffolds were then deployed and 12 months post procedure, have proven to be a successful treatment option for this rare disease.
Conclusion: This case highlights the difficulties posed by this rare disease and the potential for better results for PCI in complicated cases when biovascular scaffolds are employed. Failure of conservative management necessitated the novel approach with biovascular scaffolds which have been shown to not only restore coronary flow in the interim, but also reduce the risk of restenosis while promoting vascular restoration. Bioresorbable stents should be considered for management of certain complicated cases.

Keywords: Bioresorbable, Scaffolds, Spontaneous coronary artery dissection, Vascular restoration


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Author Contributions
Chinyere C. Iwuala – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Chinyere C. Iwuala. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.