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Case Reports
. 2025 Mar 5;30(5):103080.
doi: 10.1016/j.jaccas.2024.103080.

Managing Complex Coronary Revascularization of Acute Coronary Syndrome During Cogan Syndrome

Jacopo Giovacchini  1 , Francesco Cappelli  2 , Benedetta Tomberli  3 , Flavia Caniato  4 , Cecilia Agostini  4 , Letizia Nicolaci  4 , Letizia Giurlani  4 , Pasquale Bernardo  4 , Carlo Di Mario  5
Affiliations
Case Reports

Managing Complex Coronary Revascularization of Acute Coronary Syndrome During Cogan Syndrome

Jacopo Giovacchini et al. JACC Case Rep. .

Abstract

Cogan syndrome, a rare multisystemic autoimmune vasculitis, can result in coronaritis and precipitate acute coronary syndrome. This paper reports a case of a young woman affected by Cogan syndrome with acute coronary syndrome due to a left main lesion and the complexities in selecting the revascularization strategy for concomitant active vasculitis.

Keywords: Cogan syndrome; acute coronary syndrome; coronaritis; percutaneous coronary intervention.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Admission Electrocardiogram: Sinus Tachycardia, aVR ST-T–Segment Elevation, and Diffuse ST-T–Segment Depression
Figure 2
Figure 2
Aortic Computed Tomography Angiography 1 Irregular and thickened aortic wall with contrast enhancement compatible with active aortitis (B, red arrows), absent on the examination performed during the first emergency department access (A, red arrows).
Figure 3
Figure 3
Aortic Computed Tomography Angiography 2 Left subclavian ostial stenosis (B), absent on the examination performed during the first emergency department access (A).
Figure 4
Figure 4
Admission Selective Coronary Angiography (A and B) Subocclusion of left main trunk. (C) Final angiographic result after drug-eluting stent implant.
Figure 5
Figure 5
Total Body Fluorodeoxyglucose Positron Emission Tomography Scan (A) No remarkable aortic glucose uptake. (B) Fluorodeoxyglucose positron emission tomography/low-dose computed tomography fused image: the stent implanted (arrow) not surrounded by enhanced coronary glucose metabolism.
Figure 6
Figure 6
Follow-Up Selective Coronary Angiography Absence of in-stent restenosis.
See this image and copyright information in PMC

References

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