自发性冠状动脉夹层的临床及影像学分析

目的 分析自发性冠状动脉夹层（SCAD）的临床、影像学特点及治疗情况。 方法 回顾性分析11例SCAD患者的临床特点、造影及其他腔内影像学资料、治疗方法及预后。 结果 11例SCAD患者均为女性，冠状动脉造影可见冠状动脉呈“鼠尾样”改变，血管内超声（IVUS）或光学干涉断层成像（OCT）可确诊，其中3人行PCI手术，1人在IVUS引导下进行，手术顺利，另外2人术中植入支架时血肿扩散至血管急性闭塞，其余8人药物保守治疗，11人预后均较好，一年随访无复发。 结论 SCAD好发于中年女性，预后较好，腔内影像引导可增加PCI手术成功率。

Clinical and Imaging analysis of spontaneous coronary artery dissection

AIM To Investigate clinical features, imaging features, and treatment strategies of spontaneous coronary artery dissection (SCAD). METHODS Clinical data of 11 patients with SCAD in our hospital were analyzed retrospectively, including clinical characteristics, angiographic, and other intracoronary imaging data, treatment and prognosis of these 11 patients combined with past literature, and the etiology, predilection population, imaging features and treatment strategy of SCAD were evaluated. RESULTS All of the 11 patients with SCAD were female. Coronary angiography showed the "rat tail" sign in coronary arteries. Intravenous ultrasound (IVUS) or optical coherence tomography (OCT) was used for diagnosis. Among the 11 patients, 3 underwent percutaneous coronary intervention (PCI), 1 was guided by IVUS, while other 2 patient hematomas spread to the distal vessel causing acute occlusion of the vessel. Other 8 patients were treated conservatively. Prognosis of 11 patients was better and there was no recurrence seen in one-year follow-up. CONCLUSION SCAD is common in middle-aged women and with better prognosis. Intracoronary imaging-guided PCI of SCAD can increase the success rate.