Table 2: Suggestions to Avoid Complications During Percutaneous Coronary Interventions in Spontaneous Coronary Artery Dissection.

Avoid the use of Amplatz guiding catheters and guide catheter extension systems to prevent iatrogenic dissection.

Special focus to keep coaxial non-deep catheter intubation.

Use non-hydrophilic guidewires.

When a relevant side-branch is involved, wiring is recommended before percutaneous coronary intervention to avoid side-branch occlusion by haematoma extension.

There is a low threshold for intracoronary imaging-guided percutaneous coronary intervention use: It confirms position of the guidewire within the true lumen. It permits proper device selection (length and diameter) and stent optimisation.

In flow-limiting lesions, the objective must be to restore coronary flow. Avoid aesthetic percutaneous coronary intervention.

Device dilatation should be done gently (avoid high pressure inflation).

Cutting or scoring balloons, with or without stenting, may help to fenestrate high-pressure haematomas.

Three-stent technique (sandwich stenting) may prevent spontaneous coronary artery dissection extension by first enclosing the haematoma borders.

If feasible, avoid stent post-dilatation. If performed,the preference is for short balloons, low-pressure inflations and avoid geographic miss.