Cutting balloon angioplasty for treatment of spontaneous coronary artery dissection: case report, literature review, and recommended technical approaches

Conservative therapy is typically recommended for patients with spontaneous coronary artery dissection (SCAD). However, percutaneous coronary intervention (PCI) may have to be pursued in cases of ongoing ischemia or hemodynamic instability. There is early and increasing interest in using cutting balloon (CB) angioplasty to fenestrate the false lumen to allow communication and back-bleed of intramural hematoma into the true lumen. We report a successful case of CB angioplasty for SCAD without the need for stenting, and provide a review of the published experience and recommendation for technical approaches with this strategy.