Gülaşti Sevil, Mutlu Berk, Tuzcu Göksel, Zencır Cemil
Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey.
Department of Radiology, Adnan Menderes University School of Medicine, Aydin, Turkey.
BMC Cardiovasc Disord. 2025 May 30;25(1):416. doi: 10.1186/s12872-025-04869-4.
The presence of coronary aneurysm or ectasia has been associated with poor long-term outcomes, regardless of the presence of concomitant atherosclerotic coronary artery disease. The widespread use of new coronary imaging methods and the increase in coronary angiography applications in coronary artery disease have increased the frequency of rare coronary artery aneurysms (CAA).
A 59-year-old male patient applied to the cardiology outpatient clinic with angina that had been present for three to four months. The patient's electrocardiography was in normal with sinus rhythm and no signs of ischemia were observed. Transthoracic echocardiography revealed a52 × 47 mm mass, which was thought to be an aneurysm or cyst, causing compression on the right atrium. Cardiac MRI and computed tomography coronary angiography was performed and an aneurysm with dimensions of 62 × 57 mm, thought to originate from the right coronary artery (RCA), was observed. Coronary angiography of the patient showed a giant coronary aneurysm of the proximal segment of RCA. The patient was evaluated by the cardiac team.For treatment, a 3.5 × 48 mm Abbott Xience Pro DES was first implanted from the proximal normal coronary artery segment to the distal normal segment beyond the aneurysm, creating a stable platform for graft stent placement. Two consecutive 4.0 × 20 mm Papyrus-Biotronik graft stents were then implanted into this DES without leaving any gaps. Post-procedurally, no contrast passage into the aneurysm was observed.
Because of the absence of available guidelines, the optimal treatment method for coronary artery aneurysms remains uncertain.
无论是否伴有动脉粥样硬化性冠状动脉疾病，冠状动脉瘤或扩张的存在都与不良的长期预后相关。新型冠状动脉成像方法的广泛应用以及冠状动脉疾病中冠状动脉造影应用的增加，使得罕见冠状动脉瘤（CAA）的发生率有所上升。
一名59岁男性患者因持续三到四个月的心绞痛症状前往心脏病门诊就诊。患者心电图显示窦性心律正常，未观察到缺血迹象。经胸超声心动图显示一个52×47mm的肿块，被认为是一个动脉瘤或囊肿，对右心房造成压迫。进行了心脏磁共振成像和计算机断层扫描冠状动脉造影，观察到一个尺寸为62×57mm的动脉瘤，推测起源于右冠状动脉（RCA）。患者的冠状动脉造影显示RCA近端段存在巨大冠状动脉瘤。心脏团队对该患者进行了评估。治疗时，首先从动脉瘤近端的正常冠状动脉段至动脉瘤远端的正常段植入一枚3.5×48mm的雅培Xience Pro药物洗脱支架（DES），为移植支架置入创建一个稳定平台。然后，将两枚连续的4.0×20mm的百多力Papyrus移植支架植入该DES内，不留任何间隙。术后，未观察到造影剂进入动脉瘤。
由于缺乏可用的指南，冠状动脉瘤的最佳治疗方法仍不确定。
