Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation

Ahn, Chul Min; Hong, Bum Kee; Kim, Jong Youn; Min, Pil‐Ki; Yoon, Young Won; Lee, Byoung Kwon; Kwon, Hyuck Moon; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Hong, Myeong Ki; Jang, Yangsoo; Shim, Won Heum; Cho, Seung Yun; Kim, Byeong Keuk; Oh, Seong-Jin; Jeon, Dong Woon; Yang, Joo Young; Jung, Jae Hun

doi:10.1016/j.ahj.2010.07.013

Cited by 40 publications

(49 citation statements)

References 29 publications

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“…In adults, most coronary artery aneurysms are atherosclerotic in origin, and other underlying causes include Kawasaki disease, Takayasu arteritis (2), collagen vascular disease (3), and IgG4-related coronary periarteritis (4); in addition, coronary artery aneurysm may develop after angioplasty, especially after drug-eluting stent implantation (5). "Giant" coronary artery aneurysms, which are defined as having a diameter of 2 cm or greater, are rarer with a reported prevalence of 0.02% (6).…”

Section: Introductionmentioning

confidence: 99%

A Case of Giant Coronary Artery Aneurysm with Fistulous Connection to the Pulmonary Artery: a Case Report and Review of the Literature

et al. 2012

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Giant coronary artery aneurysm is a rare condition with a reported prevalence of 0.02%. Herein, we report the case of a 79-year-old woman with a giant coronary aneurysm arising from a branch of the left anterior descending coronary artery that had a fistulous connection to the pulmonary artery. The aneurysm was removed and inflow and outflow arteries were closed surgically. Histology showed prominent mucinous degeneration and infiltration of inflammatory cells in the medial layer. After successful surgery, the patient was discharged uneventfully.

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Section: Introductionmentioning

confidence: 99%

A Case of Giant Coronary Artery Aneurysm with Fistulous Connection to the Pulmonary Artery: a Case Report and Review of the Literature

et al. 2012

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“…[16][17][18] PCIrelated CAAs are rare and caused by chemical and mechanical factors. [19][20][21] Chemical factors include allergic reaction to metals, polymer-induced hypersensitivity, and infection, and the incidence of CAAs is higher after DES implantation than after BMS implantation. Mechanical factors include residual dissection and deep arterial wall injury due to wire insertion into the false lumen, excessive balloon or stent dilation, and SFs.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Aneurysm Caused by a Stent Fracture

et al. 2018

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SummaryCoronary stent fracture (SF) is rare as a complication of percutaneous coronary intervention (PCI), and its adverse events are increasingly being recognized with the development in devices of PCI. The major adverse events caused by SFs are in-stent restenosis due to neointimal overgrowth caused by poor drug delivery.1,2) A coronary artery aneurysm (CAA) is a rare complication of SF, but may lead to lethal events such as acute coronary syndrome or rupture of the CAA further leading to cardiac tamponade. [3][4][5] However, the management of CAAs is controversial with or without SF.6) Herein, we report a case of a CAA caused by an SF and discuss the management of CAA complicated with SF, along with a literature review. We suggest that surgical treatment should be considered the higher-priority strategy in the cases of CAA with SF as compared to CAA without SF.(Int Heart J 2018; 59: 203-208) Key words: Coronary artery disease, Drug-eluting stent, In-stent restenosis A lthough the use of drug-eluting stents (DESs) has significantly improved its long-term outcomes after percutaneous coronary intervention (PCI), instent restenosis (ISR) still occurs in some cases and target vascular revascularization is required. 7,8) Coronary stent fracture (SF) is increasingly being recognized as one of the causes of ISR.1) SF can be classified into several types, and complete and severe fracture types rarely lead to coronary artery aneurysm (CAA).9,10) Thus far, the established treatment and management for CAAs with SF are unclear. Case ReportA 69-year-old man with multiple coronary risk factors, including hypertension, hyperlipidemia, type-2 diabetes mellitus, smoking history, and chronic kidney disease, presented to our hospital for a follow-up coronary angiography (CAG) 6 months after PCI. He had undergone CAG and PCI several times as described below.In 2003, an electrocardiogram showed ST segment depression, and a cardiac exercise stress test and radioisotope revealed ischemic changes in the anterior and inferior segments of the left ventricle; therefore, CAG was performed for the first time. CAG demonstrated 90% stenosis in the proximal right coronary artery (RCA) and 75% stenosis in the proximal left anterior descending artery (LAD) with mild stenosis in the left circumflex artery (LCX). PCI was successfully performed, and bare-metal stents (BMSs; 4.0 × 13 mm and 3.5 × 20 mm) were implanted in the ostium of the RCA and proximal LAD, respectively. Six months later, in 2004, a follow-up CAG revealed no in-stent restenosis (ISR), and dual antiplatelet therapy (DAPT) was changed to single antiplatelet therapy (SAPT). In 2014, the patient was diagnosed with earlystage gastric cancer, and CAG was performed before the gastric cancer surgery. CAG revealed ISR in the RCA and progression of the stenosis in the LCX. A week before the surgery, SAPT was changed to heparin, and DAPT was started after it. Following the surgery, PCI was performed and a zotarolimus-eluting stent (Resolute Integlity 2.5 × 22 mm) was implanted in the LCX,...

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“…Moreover, Alfonso et al reported that freedom from death, MI, and TVR was 49±14% for 1 year after diagnosis of CAA; thus, the prognosis is never good. 43, 44 Kim et al reported risk factors for CAA formation after DES implantation, 45 which did not include LMCA disease. However, the causes of CAA formation after DES implantation are unknown.…”

Section: Problems Of Late Catch-up Phenomenon and Formation Of Late Cmentioning

confidence: 99%

Role of Bare-Metal Stents for Left Main Coronary Artery Disease in the Era of Drug-Eluting Stents - Which Coronary Stent Should Be Used for Left Main Trunk Disease? BMS or DES? (BMS-Side) -

Kaneko

Kijima

2011

Circ J

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Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation

Cited by 40 publications

References 29 publications

A Case of Giant Coronary Artery Aneurysm with Fistulous Connection to the Pulmonary Artery: a Case Report and Review of the Literature

A Case of Giant Coronary Artery Aneurysm with Fistulous Connection to the Pulmonary Artery: a Case Report and Review of the Literature

Coronary Artery Aneurysm Caused by a Stent Fracture

Role of Bare-Metal Stents for Left Main Coronary Artery Disease in the Era of Drug-Eluting Stents - Which Coronary Stent Should Be Used for Left Main Trunk Disease? BMS or DES? (BMS-Side) -

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