Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment

Abstract

Coronary artery aneurysms (CAAs) are uncommon and describe a localized dilatation of a coronary artery segment more than 1.5-fold compared with adjacent normal segments. The incidence of CAAs varies from 0.3 to 5.3%. Ever since the dawn of the interventional era, CAAs have been increasingly diagnosed on coronary angiography. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. The natural history of CAAs remains unclear; however, several recent studies have postulated the underlying molecular mechanisms of CAAs, and genome-wide association studies have revealed several genetic predispositions to CAA. Controversies persist regarding the management of CAAs, and emerging findings support the importance of an early diagnosis in patients predisposed to CAAs, such as in children with KD. This review aims to summarize the present knowledge of CAAs and collate the recent advances regarding the epidemiology, etiology, pathophysiology, diagnosis, and treatment of this disease.

A clinical risk score to identify patients at high risk of very late stent thrombosis

“…Coronary artery ectasia are more prevalent in the RCA than in the other coronary arteries, 31 however interaction between the three added risk factors did not shown associations between these risk factors. But the number of patients might have been too low to reveal an interaction.…”

miR-27b Suppresses Endothelial Cell Proliferation and Migration by Targeting Smad7 in Kawasaki Disease

“…KD is the most common cause of coronary artery aneurysms (CAAs) in childhood. Moreover, 15 to 25% of untreated children develop CAAs or ectasia [1] and the risk is reduced only to 5% after treatment with intravenous immunoglobin in acute KD [2,3]. However, the mechanism of KD-induced vascular injury remains unclear and no specific biomarker is available.…”

Prognostic significance, angiographic characteristics and impact of antithrombotic and anticoagulant therapy on outcomes in high versus low grade coronary artery ectasia: A long‐term follow‐up study

“…The reported prevalence of CAE varies from 1.2 to 4.9% 1,3 . The angiographic classification for CAE (described by Markis Even though CAE has been a subject of several review articles over the last few years, evidence-based understanding of the disease is quite limited 3,[5][6][7][8][9][10] . These reviews describe the clinical presentation, natural history and management options for these patients but uniformly report that there is a paucity of data in these areas.…”