Percutaneous Coronary Intervention for the Treatment of Spontaneous Coronary Artery Dissection

Most patients presenting with myocardial infarction owing to spontaneous coronary artery dissection can be managed conservatively. Revascularization should be pursued in the presence of high-risk features. Percutaneous coronary intervention is preferred over coronary artery bypass grafting, except in left main dissection. Interventionists should exercise extreme caution and meticulous techniques. Using a cutting balloon to fenestrate and decompress the false lumen is appealing and may avoid the need for long stents. Other percutaneous approaches may also be feasible, and interventionists should be familiar with these various approaches when embarking on spontaneous coronary artery dissection percutaneous coronary intervention.