Iakovou Ioannis, Dimopoulos Antonios, Dangas George
1st Cardiology Department, Onassis Cardiac Surgery Center, 356 Syggrou Ave., 17674, Athens, Greece.
J Invasive Cardiol. 2011 May;23(5):E121-5.
Coronary artery aneurysm (CAA) is defined as a coronary dilatation that exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. The presence of a CAA is not always without complications. Thrombosis with myocardial infarction, formation of arteriovenous fistulae, vasospasm, and even rupture, may occur especially with very large aneurysms. These complications dictate the need for medical, surgical or percutaneous therapy. The latter consists mainly of the use of polytetrafluoroethylene (PTFE)-covered stents. Compared to PTFE-covered stents, bare-metal stents (BMS) have better flexibility, making implantation in tortuous vessels easier, and permitting access to sidebranches when a bifurcation lesion is involved. Their use in treatment of CAA has rarely been reported. We present three cases with CAA that have been treated with BMS with excellent post-procedure angiographic results and complete exclusion of the aneurysm at mid-term angiographic follow-up.
冠状动脉瘤(CAA)的定义为冠状动脉扩张,其直径超过相邻正常节段的直径或患者最大冠状动脉血管直径的1.5倍。CAA的存在并非总是没有并发症。尤其是非常大的动脉瘤,可能会发生伴有心肌梗死的血栓形成、动静脉瘘形成、血管痉挛,甚至破裂。这些并发症决定了需要进行药物、手术或经皮治疗。后者主要包括使用聚四氟乙烯(PTFE)覆膜支架。与PTFE覆膜支架相比,裸金属支架(BMS)具有更好的柔韧性,使在迂曲血管中的植入更容易,并且在涉及分叉病变时能够进入侧支血管。其在CAA治疗中的应用鲜有报道。我们报告了3例接受BMS治疗的CAA病例,术后血管造影结果极佳,中期血管造影随访时动脉瘤完全被排除。