You could learn more about cardiology courses with Prof. Sameh Allam by clicking on the courses’ library link here:

Objectives for this course:
1- Master the essentials of a successful complex PCI by using the radial approach
2- Essential questions on radial approach and the use of the specific radial device(s)
3- Clinical case strategy and radial approach limits
4- Anatomical variations in the Radial artery.
5- Master the essential steps of a successful radial procedure.

In this lecture, we will discuss the bad face of PCI - CA dissection.
Our Agenda is:
1- Causes.
2- Risk Factors.
3- Types.
4- Diagnosis.
5- Prognosis.
6- Treatment.
7- Conclusion.

Percutaneous coronary intervention (PCI) involving drug-eluting stents is increasingly used to treat complex coronary artery disease, although coronary artery bypass grafting (CABG) has been the treatment of choice historically. Our trial compared PCI and CABG for treating patients with previously untreated three-vessel or left main coronary artery disease (or both).

Percutaneous coronary intervention (PCI) is widely utilized in the treatment of symptomatic coronary artery disease. Despite its numerous benefits, serious and potentially life-threatening complications of PCI can occur, including iatrogenic coronary artery dissection and perforation.

The incidence of these complications has been augmented by the development of coronary interventional devices intended to remove or ablate tissue. We herein review the classification, incidence, pathogenesis, clinical sequelae, and management of coronary artery dissection and perforation in the current era.

Specifically, the current angiographic classifications of coronary artery dissections and perforations are reviewed. The findings of several recent, large registries of PCI-related coronary artery perforations are summarized.
The management of coronary artery dissection and perforation is discussed at length, including the application of newer modalities such as covered stents.

SCAD (Spontaneous coronary artery dissection) is a rare but potentially life-threatening cause of acute coronary syndromes. Management may be conservative or by either percutaneous or surgical revascularization depending on the site and extent of dissection and the clinical presentation. Most available information about this condition until recently was anecdotal, but there is now increasing data from larger reported series, coupled with a recognition of the need for a systematic acquisition of prospective data. The DISCOVERY registry aims to recruit 50 consecutive patients with SCAD and should at least provide a more systematic appraisal of the outcomes of current practice.

Signs and symptoms of SCAD may include:
1- Chest pain
2- A rapid heartbeat or fluttery feeling in your chest
3- Pain in your arms, shoulders or jaw
4- Shortness of breath
5- Sweating
6- Unusual, extreme tiredness
7- Nausea
8- Dizziness

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SCAD is a tear inside an artery that carries blood to the heart. When the inner layers of the artery separate from the outer layers, blood can pool in the area between the layers. The pressure of the pooling blood can make a short tear much longer. Blood trapped between the layers can form a blood clot (hematoma).

SCAD may slow blood flow through the artery, which makes the heart muscle weaken. Or blood flow through the artery may be completely stopped, causing the heart muscle to die (heart attack). A heart attack that occurs in SCAD is different from a heart attack caused by the hardening of the arteries (atherosclerosis).

SCAD can happen more than once, despite successful treatment. It may recur soon after the initial episode or years later. People who have SCAD may also have a higher risk of other heart problems, such as heart failure due to the damage to the heart muscle from heart attacks.

In conclusion, ICAD is not infrequent during diagnostic coronary angiography or PCI in SCAD patients. Angiographers/interventionists should be aware of these heightened risks and employ meticulous techniques during angiography of SCAD patients.

Novel coronavirus disease 2019 (COVID-19) as a result of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the global pandemic that has infected over 1.5 million patients worldwide1 with cardiac manifestations and injury in up to 20–28% of patients.
COVID-19 has been documented as a cause of heart failure, acute coronary syndromes, myocardial infarction, and myocarditis leading to life-threatening arrhythmias.
Due to the risk of transmission in both symptomatic and asymptomatic patients, protocols have been rapidly instituted in order to protect patients and healthcare workers to prevent the further spread of disease.

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