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Coronary intramural hematomas: a focused review

M Shenoda & J Aragon

Intramural hematomas are defined as an accumulation of blood in the media with entry and exit points that may or may not be identifiable. Intramural hematomas can occur during percutaneous coronary interventions and have been reported to occur spontaneously. While a majority of intramural hematomas are identifiable on coronary angiography, intravascular ultrasound should be considered the gold standard for diagnosis given its superior imaging capabilities. Outcomes are variable and there are no guidelines for the treatment of intramural hematomas. Therefore, treatment of intramural hematomas should be based on patient characteristics and clinical scenario.