Stent‐assisted coil embolization for the treatment of aneurysm involving a coronary bifurcation

Abstract

Coronary artery aneurysm (CAA) is an uncommon disease with high risks of complications including rupture and ischemia from embolic events or thrombosis, especially if associated with critical stenosis of the coronary artery. No consensus document or guidelines has been established regarding the optimal therapy for concomitant CAAs and acute coronary syndrome (ACS). Percutaneous catheter-based treatments using only membrane-covered stents have been described; however, only few reports of drug-eluting stent (DES) and coil embolization for CAAs during ACS have been published to date. Therefore, we report a case of coronary artery disease with aneurysm and critical stenosis successfully treated with DES and coil embolization. © 2016 Wiley Periodicals, Inc.

Self‐apposing stent‐assisted coil embolization for the treatment of coronary artery aneurysm

“…Among adults atherosclerosis is the commonest cause of CAA (52%) . Natural history of CAA is still poorly clear and potential risks are spontaneous rupture, thrombosis, and distal embolization . Exact incidence of these complications is still unknown.…”

“…On the other hand, percutaneous treatment for coronary aneurysms is less invasive compared with surgical techniques . In stent‐assisted coil embolization of aneurysms, a microcatheter is usually placed in the aneurysm before stenting to prevent coil migration . Currently, no consensus as to which stent is better has been established .…”

“…Incidence ranges from 1.4% at autopsy to 4.9% at coronary angiography . Many are asymptomatic, and incidentally found on coronary angiography . Potential complications include rupture and ischemia from embolic events or thrombosis .…”

“…Among these techniques no clear evidence of any advantage of one over the others has been demonstrated . Furthermore a “stent‐assisted” coil embolization has been described as a valuable option to manage patients presenting with wide‐neck coronary aneurysm . Only a few reports on stent‐assisted coil embolization for CAA have been published and there's no consensus for which stent is better to use .…”

“…Furthermore a “stent‐assisted” coil embolization has been described as a valuable option to manage patients presenting with wide‐neck coronary aneurysm . Only a few reports on stent‐assisted coil embolization for CAA have been published and there's no consensus for which stent is better to use . Choice of stent (polytetrafluoroethylene (PTFE), drug eluting stent (DES), bare metal stent (BMS)) should be determined by the interventional cardiologist and the pertinent clinical details unique to each case.…”