Optical Coherence Tomography in the Diagnosis and Management of Spontaneous Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) is an infrequent condition that has been underdiagnosed and misdiagnosed. The use of intracoronary imaging with intravascular ultrasound or optical coherence tomography enables the accurate diagnosis of this challenging condition. Diagnostic and management algorithms have been proposed to improve the diagnosis and therapeutic stratification of SCAD. Optical coherence tomography has superior spatial resolution than intravascular ultrasound, and is instrumental in the diagnosis of SCAD cases where angiographic findings are ambiguous for confirming SCAD. Understanding the role and appropriate and careful use of this technology is expected to improve the diagnosis of SCAD, and also improve outcomes with percutaneous coronary intervention, when clinically indicated.