Treatment of a Spontaneous Coronary Artery Dissection Involving the Left Main Coronary Artery Using the Culotte Stent Technique

Abstract

Spontaneous coronary artery dissection (SCAD) is an extremely rare clinical manifestation of ischemic heart disease. A 43-year-old female was admitted to our hospital for non-ST elevation myocardial infarction. She had no cardiac risk factors except smoking. Coronary angiography showed moderate stenosis of the proximal left circumflex artery (LCX) with intraluminal haziness and a spastic appearance from the culprit lesion in the left main coronary artery (LM). Subsequent analysis by intravascular ultrasound (IVUS) revealed a clear dissection flap from the LCX to the LM. Generally, SCAD of the LM or multivessel involvement requires primary surgical management. The present case was treated percutaneously using the culotte stent technique.