Treatment of coronary aneurysms with covered stents: a review with illustrated case

Coronary aneurysms are found in approximately 5% of patients undergoing coronary angiography. Most coronary artery aneurysms (CAAs) are associated with significant stenosis of the coronary lumen; however, there is no common consensus on the treatment of coronary aneurysms. A large aneurysm in the co...

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Bibliographic Details
Published in:The Journal of invasive cardiology 2012-09, Vol.24 (9), p.465-469
Main Authors: Zeb, Mehmood, McKenzie, Daniel B, Scott, Paul A, Talwar, Suneel
Format: Article
Language:English
Subjects:
Aged
Coronary Aneurysm - diagnostic imaging
Coronary Aneurysm - surgery
Coronary Aneurysm - therapy
Coronary Angiography
Coronary Vessels - diagnostic imaging
Coronary Vessels - pathology
Coronary Vessels - surgery
Humans
Male
Stents
Treatment Outcome
Ultrasonography, Interventional
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Summary:Coronary aneurysms are found in approximately 5% of patients undergoing coronary angiography. Most coronary artery aneurysms (CAAs) are associated with significant stenosis of the coronary lumen; however, there is no common consensus on the treatment of coronary aneurysms. A large aneurysm in the coronary artery makes the blood flow turbulent and predisposes to thrombus formation and coronary artery obstruction even without the presence of significant stenosis. Despite this important anatomical abnormality of the coronary artery, the treatment options are poorly understood and present a therapeutic challenge to the interventional cardiologist. While treating CAAs with percutaneous implantation of covered stents offers a less invasive option compared to surgical correction, the short- and long-term outcomes are unknown. In this article, we have reviewed the literature and discussed the pathophysiology, clinical importance, and treatment options for CAAs. The illustrated case demonstrates a difficult situation in the management of CAA with interesting images, including coronary angiography, intravascular ultrasound, and transesophageal echocardiography of the complication encountered in this particular case.
ISSN:1557-2501