Endovascular management of giant coronary artery aneurysm

Chadha, D.S.; Hasija, P.K.; Singh, Navreet; Ghosh, Asok; Malani, SK

doi:10.1016/j.mjafi.2014.05.005

Cited by 2 publications

(6 citation statements)

References 9 publications

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“…Based on these characteristics, the aneurysm in our case was identified as pseudoaneurysm. Despite advances in interventional cardiology, the true incidence, clinical course, and treatment of coronary artery aneurysms after DES implantation remain largely unknown [3]. The diagnosis of coronary artery pseudoaneurysm in a patient with suspected myocardial ischemia is made on the basis of cardiac imaging procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Coronary angiography remains the gold standard as it not only provides information regarding the size, shape, location, and number of aneurysms, but also illustrates the presence or absence of associated stenosis. Other noninvasive tools such as transesophageal echocardiography, contrast-enhanced computed tomography and magnetic resonance imaging are also valuable for initial evaluation [3]. Since our patient presented with angina after DES implantation, he was taken up directly for diagnostic coronary angiogram.…”

Section: Discussionmentioning

confidence: 99%

“…A close review of available literature suggests a growing incidence of coronary artery aneurysms after implantation of drug-eluting stent (DES) in recent times. The possible pathophysiological mechanisms are: a) delayed re-endothelialization and healing secondary to the antiproliferative action of eluted drug; b) cell necrosis or apoptosis due to antimetabolite effects of the drug; c) inflammation compounded by vascular injury (residual dissections, contained perforations) secondary to the hypersensitivity reaction to metal, polymer, or drug; or d) acquired late stent malapposition [1]- [3].…”

Section: Introductionmentioning

confidence: 99%

“…The onset of coronary aneurysm formation has been reported from 3 days to 4 years after the DES implantation, with a varied presentation from asymptomatic state to severe angina. Some aneurysms resolve naturally, while others may lead to life-threatening complications such as rupture, thrombosis, embolization, myocardial infarction, and even sudden death [3]. A study has reported that the incidence of coronary aneurysm after DES implantation is more common in left anterior descending artery (LAD), followed by right coronary artery (RCA), and rarely in left circumflex artery (LCX) [4].…”

Section: Introductionmentioning

confidence: 99%

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Giant Coronary Artery Pseudoaneurysm after Drug-Eluting Stent Implantation

Bhupali¹,

Joshi²,

Patil³

et al. 2015

IJCM

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Formation of coronary artery pseudoaneurysm after percutaneous coronary intervention is rarely reported. A close review of available literature indicates a trend of growing incidence in recent times. Here, we present a case of coronary pseudoaneurysm developing in the left circumflex artery within 50 days of sirolimus-eluting stent implantation in a 47-year-old man who was treated for triple-vessel coronary artery disease. Initially, the patient refused any further treatment. However, considering the rapid growth of pseudoaneurysm and increased severity of symptoms at subsequent follow-up, we decided to treat giant pseudoaneurysm with embolization coils. The procedure was successful and the patient remained asymptomatic thereafter.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Giant Coronary Artery Pseudoaneurysm after Drug-Eluting Stent Implantation

Bhupali¹,

Joshi²,

Patil³

et al. 2015

IJCM

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“…Pseudoaneurysm (PSA) formation is a rare but well‐known complication of coronary stenting 1‐36 . It develops after a perforation disrupts the integrity of the vessel wall but is contained by extravascular thrombosis, fibrosis, and pericardial constraint.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of the evaluation and management of coronary pseudoaneurysm after stent implantation

Hassan

Uretsky

Estrada

et al. 2020

Cathet Cardio Intervent

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Pseudoaneurysm (PSA) formation is a rare but well‐known complication of coronary stenting. It develops after a procedural perforation disrupts the integrity of the vessel wall but is contained by a single wall layer, usually pericardium, extravascular thrombosis and later fibrosis. Medical literature of PSA consists primarily of case reports. A systematic review of pseudoaneurysm after coronary stenting was performed to summarize its presentation, diagnostic imaging modalities, natural history, and management approaches. Clinical presentations range from asymptomatic to hemodynamic collapse, size from small to “giant,” and treatment approaches from surgical or percutaneous exclusion to “watchful waiting” and imaging surveillance. Based on current information, a management algorithm is provided recommending urgent to emergent exclusion for symptomatic PSA, elective exclusion for large and giant PSA, and “watchful waiting” and periodic imaging surveillance for small to moderate sized PSA.

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Endovascular management of giant coronary artery aneurysm

Cited by 2 publications

References 9 publications

Giant Coronary Artery Pseudoaneurysm after Drug-Eluting Stent Implantation

Giant Coronary Artery Pseudoaneurysm after Drug-Eluting Stent Implantation

Systematic review of the evaluation and management of coronary pseudoaneurysm after stent implantation

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