Intravascular Ultrasound Imaging in the Diagnosis and Treatment of Spontaneous Coronary Dissection With Drug-Eluting Stents

Italo Porto, MD; Adrian P. Banning, MRCP, MD

Disclosures

J Invasive Cardiol. 2004;16(2) 

In This Article

The Future: IVUS-Guided DES Implantation?

We believe that the combined use of IVUS and DES is the optimal management for this condition. IVUS in SCAD patients has already been described;[29,30] it is useful to differentiate atherosclerotic disease from SCAD in cases with ambiguous coronary angiography, to determine the morphology and the real extension of dissection (risk of occult dissection), to confirm correct guidewire placement before stenting (risk of false-lumen stenting), to confirm stent apposition, symmetry and expansion, and to rule out dissection extension. In our case, IVUS confirmed the absence of an extended distal dissection before stenting, allowed us to select the correct stent lengths, and also showed the presence of an unsealed dissection in the enlarged segment, which was angiographically silent and was corrected with high-pressure postdilatation.

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