SCAD CT Angiography

This study proposes a novel screening SCAD CT angiogram protocol to detect extracoronary vascular abnormalities in SCAD patients.

Previous research has pointed to associations between the presence of extracoronary vascular abnormalities and occurrences of SCAD. A screening technique called magnetic resonance angiography (MRA) has been successfully used to detect fibromuscular dysplasia (FMD) in the renal artery, while catheter angiography has detected extracoronary vascular abnormalities in carotid and femoral arteries. Mayo Clinic SCAD researchers are working to identify the optimal screening modality to detect extracoronary vascular abnormalities.

In the protocol currently being studied, participants receive an outpatient exam, consisting of a single CT angiogram of the neck with their arms down, immediately followed by another CT angiogram of the chest, abdomen and pelvis with their arms up. All exams are performed with radiation dose modulation techniques and reviewed by dedicated vascular radiologists.

So far, the novel protocol has been successfully performed in 98 percent of participants. Extracoronary vascular abnormalities have been detected in more than two-thirds of the scanned patients. Specific types of abnormalities identified include FMD, aneurysms, dissection and aortic tortuosity, and have been seen in the aorta, carotid, vertebral, iliac, renal and mesenteric arteries.

Initial results demonstrate that the extent of extracoronary vascular abnormalities detected using the experimental protocol is higher and more extensive than in prior series using whole-body MRA. The new protocol is not as invasive as catheter angiography. Further research is needed to determine the optimal imaging technique and follow-up for SCAD patients.

Initial findings from this project have been published. Research in this area is ongoing.