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REVIEW ARTICLE
Year : 2019  |  Volume : 20  |  Issue : 3  |  Page : 101-108

Coronary artery aneurysm: Evaluation, prognosis, and proposed treatment strategies


1 Department of Cardiology, University Hospital of Wales, Cardiff, UK
2 Department of Cardiology, Morriston Hospital, Swansea, UK

Correspondence Address:
Dr. Azeem S Sheikh
Interventional Fellow, Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_1_19

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Coronary artery aneurysm is a rare disorder, which occurs in 0.3%–4.9% of patients undergoing coronary angiography. Atherosclerosis accounts for >90% of coronary artery aneurysms in adults, whereas Kawasaki disease is responsible for most cases in children. Recently, with the advent of implantation of drug-eluting stents, there are increasing reports suggesting stents causing coronary aneurysms, months or years after the procedure. The pathophysiology of coronary artery aneurysm is not completely understood but 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. 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. The natural history and prognosis remain unclear. Despite the important anatomical abnormality of the coronary artery, the treatment options of coronary artery aneuryms are still poorly defined and present a therapeutic challenge. We describe four cases, which were managed differently followed by a review of the current literature and propose some treatment strategies.


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