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Review
. 2022 Oct 19;12(10):2534.
doi: 10.3390/diagnostics12102534.

Coronary Arteries Aneurysms: A Case-Based Literature Review

Giuseppe Vadalà  1 , Leandro Di Caccamo  2 , Chiara Alaimo  2 , Luca Di Fazio  2 , Giovanni Ferraiuoli  2 , Giancarlo Buccheri  2 , Vincenzo Sucato  1   2 , Alfredo Ruggero Galassi  2
Affiliations
Review

Coronary Arteries Aneurysms: A Case-Based Literature Review

Giuseppe Vadalà et al. Diagnostics (Basel). .

Abstract

Coronary artery aneurysm (CAA) is an abnormal dilatation of a coronary artery segment; those coronary artery aneurysms that are very large in size are defined as giant. However, a standardized dimension cut-off to define giant CAAs is still missing. The reported prevalence of coronary aneurysms in the population who underwent coronary angiography ranges from 0.3% to 5%, and often CAAs are found in patient with aneurysms in other sites, such as the ascending or abdominal aorta. In half of the cases an atherosclerotic etiology could be recognized; often, CAA is found in the context of acute coronary syndrome. Seldomly, CAA is found at the autopsy of patients who died due to sudden cardiac death. Currently, very few data exist about CAA management and their prognostic relevance; moreover, CAA treatment is still not clearly codified, but rather case-based. Indeed, currently there are no published dedicated studies exploring the best medical therapy, i.e., with antiplatelets or anticoagulant agents rather than an interventional approach such as an endovascular or surgical technique. In this review, through two clinical cases, the current evidence regarding diagnostic tools and treatment options of CAAs will be described.

Keywords: cardiac surgery; coronary artery aneurysm; giant coronary artery aneurysm; percutaneous coronary intervention.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Coronary Artery Aneurysm management. CT (coronary tomography); CABG (coronary artery bypass graft); IVUS (IntraVascular UltraSound); OCT (Optical coherence tomography).
Figure 2
Figure 2
(A,B) Coronary angiography. (A) Proximal LAD giant aneurysm (white arrow) followed by a severe stenosis. Proximal left circumflex artery ectasia (blue arrow). (B) Proximal left circumflex artery ectasia (blue arrow) followed by a severe stenosis of the distal segment. Proximal LAD giant aneurysm (white arrow) (C,D) MSCTA Cardiac short and long axis view showing both ascending aorta (white asterisk) and LAD aneurysms (white arrow). (E) 3D aortic reconstruction image: Ascending (white asterisk) and infra-renal aortic aneurysms (blue asterisk) and LAD aneurysm (white arrow). LAD (left anterior descending); MSCTA (multi-slice computed tomography angiography).
Figure 3
Figure 3
Right coronary artery angiography. (A) Diffuse ectasia with a thrombotic occlusion of an aneurismatic posterolateral artery (white asterisk). (B) Persistent thrombotic occlusion after balloon dilatation, during eptifibatide infusion (white asterisk). (C) Recanalization of the distal posterolateral branch with persistent parietal thrombotic stratification after 3 days from PC (white asterisk).
See this image and copyright information in PMC

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