Gziut Aneta I, Gil Robert J
Department of Cardiology, Central Clinical Hospital Ministry of Interior and Administration, Warszawa, Poland.
Pol Arch Med Wewn. 2008 Dec;118(12):741-6.
Coronary aneurysms represent anomalies identified in 0.15-4.9% of patients undergoing coronary angiography. At present there is no uniform definition of this pathology. According to current definitions, the term "aneurysm" refers to both diffuse over 150% dilation of the largest diameter of a coronary artery, and limited spherical or saccular dilation. Aneurysms are observed most commonly in the right coronary artery, and least frequently in the left main coronary artery. It has been demonstrated that atherosclerosis is the main cause of these anomalies in adults, and Kawasaki disease in children and adolescents. However, regardless of the pathogenesis of the aneurysm, pathology of the media of the blood vessel plays a major role in its formation. The most prevalent consequence of aneurysms in the coronary arteries is formation of a thrombus with distal embolization, vasospasm or vessel disruption at the site of wall injury. Therefore, therapeutic management in this anomaly involves both the prevention of thromboembolic complications and percutaneous or surgical closure of the aneurysm entry.
冠状动脉瘤是在0.15%至4.9%接受冠状动脉造影的患者中发现的异常情况。目前，对于这种病理情况尚无统一的定义。根据当前的定义，“动脉瘤”一词既指冠状动脉最大直径弥漫性扩张超过150%，也指局限性球形或囊状扩张。动脉瘤最常见于右冠状动脉，最少见于左主冠状动脉。已经证明，动脉粥样硬化是成人这些异常情况的主要原因，而川崎病是儿童和青少年的主要原因。然而，无论动脉瘤的发病机制如何，血管中膜的病理变化在其形成中起主要作用。冠状动脉瘤最常见的后果是形成血栓并伴有远端栓塞、血管痉挛或壁损伤部位的血管破裂。因此，这种异常情况的治疗管理既包括预防血栓栓塞并发症，也包括对动脉瘤入口进行经皮或手术闭合。
