Clinical and Angiographic Features of Coronary Artery Aneurysm: A Case Series from Tertiary Hospital

Dr P. P. Deshmukh, Dr. Shahryar Khan, Dr. Shireen Khan

Abstract: Coronary artery aneurysm is one of the rare disorders, which occurs in 0.3%? 4.9% of patients undergoing coronary angiography. In adults, the most common cause is Atherosclerosis, which accounts for >90%, while in children Kawasaki disease is responsible for most cases. Recently, with the advent of coronary intervention with the implantation of drug-eluting stents, there are increasing reports suggesting stents cause coronary aneurysms, days months, or years after the procedure. The exact pathophysiology of coronary artery aneurysm is not completely understood till now but it is thought to be similar to that for aneurysms of larger vessels, with the destruction of arterial media, thinning of the arterial wall, increased wall stress, and progressive dilatation of the coronary artery segment. For diagnosis Coronary angiography remains the gold standard tool, providing information about the size, shape, and location and is also useful for planning the strategy of surgical resection. Computed tomography and cardiac MRI can also be useful. The natural history and prognosis of coronary artery aneurysm remain unclear. Despite the important anatomical abnormality of the coronary artery, the treatment options of coronary artery aneurysm are still poorly defined and present a therapeutic challenge .We describe clinical and angiographic features of four cases, which were managed differently followed by a review of the current literature.

Keywords: coronary artery aneurysm, atherosclerosis, Kawasaki disease, coronary angiography, drug-eluting stents