Coronary angiography dissection

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

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Overview

A coronary artery dissection refers to a split or a tear in the wall of the artery which compresses or compromises the lumen of the artery reducing blood flow. According to the NHLBI (National Heart Lung and Blood Institute) scheme, dissection is defined as an intraluminal filling defect or flap associated with a hazy, ground-glass appearance. This category is sub-classified using the NHLBI system for grading dissection types into type A, B, C, D, E and F.

Examples

Type A

Radiolucent areas within the coronary lumen during contrast injection, with minimal or no persistence of contrast after dye has cleared.

Click here for angiography examples on type A coronary artery dissection.

Type B

Parallel tracts or double lumen separated by a radiolucent area during contrast injection, with minimal or no persistence after dye has cleared.

Click here for angiography examples on type B coronary artery dissection.

Type C

Contrast outside the coronary lumen, with persistence of contrast in the area after dye has cleared.

Click here for angiography examples on type C coronary artery dissection.

Type D

Spiral luminal filling defects frequently with extensive contrast staining of the vessel.

Click here for angiography examples on type D coronary artery dissection.

Type E

New persistent filling defectsthat may be caused by thrombus.

Click here for angiography examples on type E coronary artery dissection.

Type F

These are non A – E dissection types that lead to impaired flow or total occlusion of the coronary artery.

Click here for angiography examples on type F coronary artery dissection.

References


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