右冠状动脉慢性完全闭塞病变再通后巨大冠状动脉瘤形成

A Giant Coronary Aneurysm Formation After RCA CTO Recanalization.

作者信息

Haokao Gao, Genrui Chen, Weiwei Xie, Wangwei Yang, Chengxiang Li

机构信息

Department of Cardiology, the First Affiliated Hospital of Air Force Military Medical University, Xi'an, China.

出版信息

JACC Case Rep. 2025 May 14;30(10):103321. doi: 10.1016/j.jaccas.2025.103321.

DOI:10.1016/j.jaccas.2025.103321

PMID:40379378

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12145022/

Abstract

Formation of a coronary artery aneurysm (CAA), especially a giant CAA, after percutaneous coronary intervention for chronic total occlusion (CTO) is a rare complication. Therapeutic approaches include surgical procedure, covered stent, and medical treatment. Here, we report a 47-year-old man readmitted due to chest distress who had undergone right coronary artery CTO recanalization 6 months earlier. Diagnostic coronary artery angiography revealed a giant aneurysm at the stented middle segment of the right coronary artery; it was >20 mm in diameter. This is the first report on a secondary giant CAA after CTO recanalization that was subsequently excluded with deployment of a covered stent.

摘要

经皮冠状动脉介入治疗慢性完全闭塞病变（CTO）后形成冠状动脉瘤（CAA），尤其是巨大冠状动脉瘤，是一种罕见的并发症。治疗方法包括外科手术、覆膜支架置入和药物治疗。在此，我们报告一例47岁男性患者，因胸部不适再次入院，该患者6个月前接受了右冠状动脉CTO再通术。诊断性冠状动脉造影显示右冠状动脉支架置入的中段有一个巨大动脉瘤，直径>20mm。这是首例关于CTO再通术后继发性巨大冠状动脉瘤并随后通过覆膜支架置入得以排除的报告。