Güvenç Rengin Çetin, Al Arfaj Abdullah Ayar, Razouk Hola, Güvenç Tolga Sinan
Department of Cardiology, Okan University School of Medicine, 34959 Istanbul, Turkey.
Department of Cardiology, Istinye University School of Medicine, 34396 Istanbul, Turkey.
Rev Cardiovasc Med. 2025 Aug 28;26(8):39702. doi: 10.31083/RCM39702. eCollection 2025 Aug.
Coronary artery aneurysms (CAAs) are frequent entities that are encountered in up to 8% of patients undergoing coronary imaging. The most frequent cause of CAAs is atherosclerotic "positive remodeling" of coronary arteries, while congenital, inflammatory, and traumatic etiologies could also be seen. Aneurysms serve as foci for thrombus formation, which may occlude the aneurysmatic segment or embolize distally. Rupture of an aneurysm is a rare yet potentially catastrophic complication of a CAA. Most aneurysms can be managed medically, while percutaneous exclusion of an aneurysm from coronary circulation is appropriate for CAAs that are prone to rupture or thrombosis. Surgical correction remains the ultimate option for patients who are not amenable to percutaneous management or those with a compelling indication for surgery. This review summarizes the available knowledge on the nomenclature, classification, pathophysiology, diagnosis, and management of CAAs, with a particular emphasis on treatment strategies to mitigate the risks associated with CAAs.
冠状动脉瘤（CAAs）是常见的病变，在接受冠状动脉成像的患者中，其发生率高达8%。冠状动脉瘤最常见的病因是冠状动脉的动脉粥样硬化性“正向重塑”，同时也可见先天性、炎症性和创伤性病因。动脉瘤是血栓形成的病灶，血栓可能阻塞动脉瘤段或向远端栓塞。动脉瘤破裂是冠状动脉瘤一种罕见但可能具有灾难性的并发症。大多数动脉瘤可以通过药物治疗，而对于易于破裂或形成血栓的冠状动脉瘤，经皮将动脉瘤排除在冠状动脉循环之外是合适的。对于不适合经皮治疗的患者或有明确手术指征的患者，手术矫正仍是最终选择。本综述总结了关于冠状动脉瘤的命名、分类、病理生理学、诊断和治疗的现有知识，特别强调了降低冠状动脉瘤相关风险的治疗策略。
