Objective To explore the value of coronary computed tomographic angiography (CCTA) in follow-up of patients with spontaneous coronary intramural hematoma (SCIH).

Methods From 2015 to 2018, ten patients with SCIH were selected from the Department of Cardiology, Zhongshan Hospital, Fudan University. The initial coronary angiography and follow-up CCTA images were compared, and the coronary vessel lumen diameter at the lesion was measured and compared.

Results Ten patients with eleven affected coronary arteries were included. The left anterior descending coronary artery with type 2 SCIH was the most common target. The average diametes of the proximal and distal segments of the lesions were (1.54±0.18) mm and (0.78±0.17) mm, respectively. Six patients were given conservative treatment, and percutaneous coronary intervention with stent implantation was performed in four patients. None of the ten patients had chest tightness or chest pain after discharge. The average follow-up time of CCTA was (8.2±5.2) months. The coronary arteries recovered entirely without any coronary dissection or intramural hematoma in 6 patients stents were unobstructed without restenosis or hematoma in 4 patients. The mean diameter of the proximal segment of previous lesions with and without stent implantation was (3.33±0.58) mm and (2.60±0.14) mm, respectively. The mean diameter of the distal segment of previous lesions was (1.59±0.30) mm. But the ending and side branches of affected coronary arteries were invisible in CCTA.

Conclusions CCTA is the preferred follow-up method for SCIH patients, but it cannot completely and clearly display the ending segment and fine branches of coronary artery.