The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

EDITORIAL

Natural history of spontaneous coronary artery dissection: to stent or not to stent?

EuroIntervention 2019;14:1353-1356. DOI: 10.4244/EIJV14I13A245

Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, Canada


Observations from contemporary spontaneous coronary artery dissection (SCAD) case series have led to expert consensus recommendations that conservative therapy is preferred and, in the absence of high-risk features such as ongoing ischaemia, left main dissection, electrical or haemodynamic instability, should be the first-line treatment strategy for SCAD1-3. This is based on the premise that the majority of SCAD arteries heal spontaneously, and that revascularisation is associated with high failure rates. Nevertheless, revascularisation is necessary in a minority of SCAD patients, and the optimal approach is controversial given the lack of randomised trial data. As such, long-term observational real-world ...

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