Coronary artery tortuosity: a narrative review
| Autor: | Gerald Chi, Mehrian Jafarizade, Anmol Pitliya, Farima Kahe, Shaghayegh Habibi, Sadaf Sharfaei, Soroush Seifirad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome medicine.medical_treatment Coronary Vessel Anomalies Myocardial Ischemia Fibromuscular dysplasia Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Tortuosity 03 medical and health sciences 0302 clinical medicine Age Distribution Percutaneous Coronary Intervention Risk Factors Takotsubo Cardiomyopathy Internal medicine Medicine Fibromuscular Dysplasia Humans Clinical significance 030212 general & internal medicine Vascular Diseases Sex Distribution Connective Tissue Diseases Incidental Findings biology business.industry Stent General Medicine Coronary Lesion Complexity medicine.disease Atherosclerosis Coronary Vessels medicine.anatomical_structure Hypertension biology.protein Cardiology Stents Stress Mechanical Cardiology and Cardiovascular Medicine business Elastin Artery |
| Zdroj: | Coronary artery disease. 31(2) |
| ISSN: | 1473-5830 |
| Popis: | Coronary artery tortuosity (CAT) is a prevalent angiographic finding commonly associated with aging, hypertension, atherosclerosis and other conditions. Preliminary evidence suggests that degradation of elastin, a key component of extracellular matrix in the vascular wall, may be responsible for the development of CAT. The clinical significance of CAT should be considered in several aspects. First, coronary flow alteration associated with CAT may result in myocardial ischemia owing to reduced perfusion pressure distal to the tortuous segment. Second, increased and oscillatory shear stress in the tortuous vessel may promote atherosclerotic plaque formation and acute coronary syndrome. Third, as one of the criteria for coronary lesion complexity, the presence of severe tortuosity proximal to the culprit lesion may pose a challenge to wiring and stent or balloon delivery, thereby increasing the risk of periprocedural complications. Last, the presence of CAT may serve as a diagnostic clue of concurrent vasculopathy such as fibromuscular dysplasia or spontaneous coronary artery dissection. In general, CAT represents a benign entity that does not require specific treatment or intervention. Further research is warranted to elucidate the pathogenesis and prognostic effect of coronary tortuosity. |
| Databáze: | OpenAIRE |
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