Screening of extra-coronary arteriopathy with magnetic resonance angiography in patients with spontaneous coronary artery dissection: a single-centre experience
| Autor: | Manuel Moreu, Carlos Macaya, Javier Escaned, María José Pérez-Vizcayno, Carlos H. Salazar, Leopoldo Pérez de Isla, Santiago Rosati, Juan Arrazola, Antonio Fernández-Ortiz, David Adlam, Pablo Salinas, Virginia Ruiz-Pizarro, Eduardo Pozo, Andrés Aldazábal, Reddy Guerra, Fernando Macaya, Nieves Gonzalo |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Fibromuscular dysplasia 030204 cardiovascular system & hematology Spontaneous coronary artery dissection (SCAD) Splenic artery medicine.disease Trunk Magnetic resonance angiography 03 medical and health sciences 0302 clinical medicine medicine.artery Medicine Original Article In patient Radiology Cardiology and Cardiovascular Medicine business Scad Artery dissection 030217 neurology & neurosurgery |
| Zdroj: | Cardiovascular Diagnosis and Therapy. 9:229-238 |
| ISSN: | 2223-3660 2223-3652 |
| DOI: | 10.21037/cdt.2019.04.09 |
| Popis: | Background: Current consensus recommends extended vascular investigation in patients with spontaneous coronary artery dissection (SCAD). We here report our experience with the use of magnetic resonance angiography (MRA) for screening extra-coronary arteriopathy in patients presenting with SCAD. Methods: Patients presenting with SCAD in a Spanish centre underwent prospective contrast-enhanced MRA to assess the cephalic and abdominopelvic arterial territories. Fibromuscular dysplasia (FMD) was diagnosed following European consensus criteria. Other vascular abnormalities were recorded separately. Two vascular radiologists supervised the acquisitions and independently analysed the results for all cases. Results: Forty patients with SCAD [mean age 50.9±8.6 years, 90% (n=36) women] were included in the study, 12 patients declined to participate and 5 were excluded (metallic implanted devices). All enrolled patients underwent the screening protocol without complications. MRA demonstrated at least one extra-coronary vascular abnormality in 16 patients (40%): 5 (12.5%) were diagnosed with FMD, 6 (15%) showed arterial tortuosity, 3 (7.5%) had non-FMD focal stenoses, and 2 (5%) were found to have small aneurysms at the celiac trunk and splenic artery. No intracranial aneurysms were detected. At a mean follow-up of 4±3 years from the index episode, two cases experienced SCAD recurrences, one in a patient with FMD and the other one in a patient with arterial tortuosity. No deaths or strokes occurred. Conclusions: Systematic extended vascular study with MRA was feasible and demonstrated associated extra-coronary arteriopathy in a substantial proportion of patients presenting with SCAD; however, none required additional intervention or led to vascular events. MRA, being a radiation-free modality, may be the preferred method for screening extracoronary arteriopathy in SCAD, a condition primarily affecting young and middle-age women sensitive to the risks of radiation. |
| Databáze: | OpenAIRE |
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