Nakano M, Horikoshi S, Emoto H, Okuyama H, Arai T, Kurosawa H
Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Sep;40(9):1738-43.
A case of 50-year-old man who developed coronary aneurysm at the initial PTCA site following dilatation was reported. The patient was suffered severe effort angina pectoris and admitted to our hospital. Coronary angiography revealed 99% stenosis in the right coronary artery (RCA), and the underwent balloon dilatation of the RCA lesion with 3.0 mm balloon catheter at 3 atm of pressure. PTCA provided sufficient coronary dilatation, however a small dissection remained. He was discharged from the hospital without any symptom. Two months after PTCA he was suffered from recurrent angina, and electrocardiographic exercise stress test was positive for ST segment depression in inferior wall. The repeat coronary angiography showed severe stenosis of the original lesion and aneurysm formation at the area of dissection which occurred during initial angioplasty. Coronary artery bypass surgery with a saphenous vein graft performed successfully.