Kuno Toshiki, Numasawa Yohei, Sugiyama Kazutoshi, Yamazaki Hiroyuki, Motoda Hiroyuki, Kamei Syusaku, Takahashi Toshiyuki
Department of Cardiology, Ashikaga Red Cross Hospital, Japan.
Intern Med. 2015;54(9):1057-62. doi: 10.2169/internalmedicine.54.2908. Epub 2015 May 1.
Coronary artery ectasia (CAE) is defined as a coronary artery dilatation with a diameter ≥1.5 times greater than that of a normal adjacent artery. All 3 coronary vessels can be affected by CAE, but the incidence of multivessel CAE among patients undergoing coronary angiography is quite low. We herein report an extremely rare case of acute myocardial infarction due to massive thrombi in the giant right coronary artery with multivessel CAE. Thrombus aspiration during percutaneous coronary intervention may be limited in giant coronary artery cases, and systemic thrombolysis may be effective in patients with massive thrombi in the giant coronary artery.
冠状动脉扩张（CAE）被定义为冠状动脉直径扩张至比相邻正常动脉直径大≥1.5倍。所有三支冠状动脉均可受CAE影响，但在接受冠状动脉造影的患者中，多支血管CAE的发生率相当低。我们在此报告一例极为罕见的因巨大右冠状动脉内大量血栓形成且伴有多支血管CAE导致的急性心肌梗死病例。在巨大冠状动脉病例中，经皮冠状动脉介入治疗期间的血栓抽吸可能受限，而全身溶栓治疗可能对巨大冠状动脉内有大量血栓的患者有效。
