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Sannino M, Nicolai M, Infusino F, Giulio L, Usai TL, Biscotti G, Azzarri A, De Angelis D’Ossat M, Calcagno S, Calcagno S. Coronary Artery Aneurysms: A Clinical Case Report and Literature Review Supporting Therapeutic Choices. J Clin Med 2024; 13:5348. [PMID: 39336835 PMCID: PMC11432381 DOI: 10.3390/jcm13185348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/31/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysms (CAAs) are uncommon but significant cardiovascular abnormalities characterized by an abnormal increase in vascular diameter. CAAs are classified based on their shape as either saccular or fusiform, and their causes can range from atherosclerosis, Kawasaki disease, to congenital and iatrogenic factors. CAAs often present asymptomatically, but when symptoms occur, they can include angina, myocardial infarction, or even sudden cardiac death due to intravascular thrombosis involving the CAA. Diagnosis is typically confirmed through coronary angiography, though CT and other imaging techniques can provide additional details. The management of CAAs is variable depending on their size, location, and the presence of symptoms or complications. Treatment options include medical therapy, percutaneous coronary intervention (PCI), or surgical approaches. In this paper, we describe the case report of a 79-year-old male who presented with palpitations and was diagnosed with a right coronary artery aneurysm, and a review of the literature is delineated, underscoring the importance of individualized treatment strategies for CAAs.
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Affiliation(s)
- Michele Sannino
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Matteo Nicolai
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Fabio Infusino
- Division of Cardiology, S. Giovanni Evangelista Hospital, 00019 Tivoli, Italy;
| | - Luciani Giulio
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Tommaso Leo Usai
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Giovanni Biscotti
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Alessandro Azzarri
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Marina De Angelis D’Ossat
- Radiodiagnostic Unit, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.N.); (M.D.A.D.)
| | - Sergio Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
| | - Simone Calcagno
- Cardiology Unit, Department of Emergency and Admission, San Paolo Hospital, Largo Donatori di Sangue 1, 00053 Civitavecchia, Italy; (M.S.); (L.G.); (T.L.U.); (G.B.); (A.A.); (S.C.)
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Woźniak P, Iwańczyk S, Błaszyk M, Stępień K, Lesiak M, Mularek-Kubzdela T, Araszkiewicz A. Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment. Biomedicines 2024; 12:1984. [PMID: 39335497 PMCID: PMC11428638 DOI: 10.3390/biomedicines12091984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 08/19/2024] [Accepted: 08/29/2024] [Indexed: 09/30/2024] Open
Abstract
Coronary artery aneurysm or ectasia (CAAE) is a term that includes both coronary artery ectasia (CAE) and coronary artery aneurysm (CAA), despite distinct phenotypes and definitions. This anomaly can be found in 0.15-5.3% of coronary angiography. CAE is a diffuse dilatation of the coronary artery at least 1.5 times wider than the diameter of the normal coronary artery in a patient with a length of over 20 mm or greater than one-third of the vessel. CAE can be further subdivided into diffuse and focal dilations by the number and the length of the dilated vessels. Histologically, it presents with extensive destruction of musculoelastic elements, marked degradation of collagen and elastic fibers, and disruption of the elastic lamina. Conversely, CAA is a focal lesion manifesting as focal dilatation, which can be fusiform (if the longitudinal diameter is greater than the transverse) or saccular (if the longitudinal diameter is smaller than the transverse). Giant CAA is defined as a 4-fold enlargement of the vessel diameter and is observed in only 0.02% of patients after coronary. An aneurysmal lesion can be either single or multiple. It can be either a congenital or acquired phenomenon. The pathophysiological mechanisms responsible for the formation of CAAE are not well understood. Atherosclerosis is the most common etiology of CAAE in adults, while Kawasaki disease is the most common in children. Other etiological factors include systemic connective tissue diseases, infectious diseases, vasculitis, congenital anomalies, genetic factors, and idiopathic CAA. Invasive assessment of CAAE is based on coronary angiography. Coronary computed tomography (CT) is a noninvasive method that enables accurate evaluation of aneurysm size and location. The most common complications are coronary spasm, local thrombosis, distal embolization, coronary artery rupture, and compression of adjacent structures by giant coronary aneurysms. The approach to each patient with CAAE should depend on the severity of symptoms, anatomical structure, size, and location of the aneurysm. Treatment methods should be carefully considered to avoid possible complications of CAAE. Simultaneously, we should not unnecessarily expose the patient to the risk of intervention or surgical treatment. Patients can be offered conservative or invasive treatment. However, there are still numerous controversies and ambiguities regarding the etiology, prognosis, and treatment of patients with coronary artery aneurysms. This study summarizes the current knowledge about this disease's etiology, pathogenesis, and management.
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Affiliation(s)
- Patrycja Woźniak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Sylwia Iwańczyk
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Maciej Błaszyk
- Department of Radiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Konrad Stępień
- Department of Coronary Artery Disease and Heart Failure, Jagiellonian University Medical College, Prądnicka 80 Street, 31-202 Kraków, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Tatiana Mularek-Kubzdela
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
| | - Aleksander Araszkiewicz
- 1st Department of Cardiology, Poznan University of Medical Sciences, Długa 1/2 Street, 61-848 Poznań, Poland
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Lionakis N, Briasoulis A, Zouganeli V, Koutoulakis E, Kalpakos D, Xanthopoulos A, Skoularigis J, Kourek C. Coronary Artery Aneurysms: Comprehensive Review and a Case Report of a Left Main Coronary Artery Aneurysm. Curr Probl Cardiol 2023; 48:101700. [PMID: 36931332 DOI: 10.1016/j.cpcardiol.2023.101700] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of noninvasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method. There is still no consensus about the most appropriate therapeutic strategy. Medical therapy including antiplatelets, anticoagulants, statins and ACEs are preferred either in patients with atherosclerosis, inflammatory status and stable CAAs, while percutaneous or surgery interventions are usually applied in patients with acute coronary syndrome due to a CAA culprit, obstructive coronary artery disease or large saccular aneurysms at a high risk of rupturing.
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Affiliation(s)
- Nikolaos Lionakis
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece; Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa Hospitals and Clinics, IA 52242, United States
| | - Virginia Zouganeli
- Second Cardiology Department, Attikon University Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 12462, Greece
| | - Emmanouil Koutoulakis
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Dionisios Kalpakos
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Andrew Xanthopoulos
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - John Skoularigis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - Christos Kourek
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece.
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"Floating" Stent in a Coronary Aneurysm Presenting as ST-Elevation Myocardial Infarction. J Cardiovasc Dev Dis 2023; 10:jcdd10020059. [PMID: 36826555 PMCID: PMC9962825 DOI: 10.3390/jcdd10020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/17/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Coronary artery aneurysm (CAA) presenting as an ST-elevation myocardial infarction (STEMI) represents a clinical challenge due to the technical difficulties in the percutaneous management of this specific situation. Appropriate treatment for CAA depends on the precise clinical situation and consists of medical management, surgical resection, or/and stent placement. The high rate of complications during percutaneous intervention (distal thrombus embolization, no-reflow phenomenon, stent malposition, or dissection) makes emergent surgery a frequent situation in these cases. We present the case of a 50-year-old man with a STEMI due to thrombotic occlusion of CAA. Specific angiographic techniques and intracoronary imaging help with the percutaneous management of acute thrombotic occlusions in CAA, providing a less invasive approach than emergent surgery.
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Ye Z, Dong XF, Yan YM, Luo YK. Coronary artery aneurysm combined with myocardial bridge: A case report. World J Clin Cases 2021; 9:3996-4000. [PMID: 34141758 PMCID: PMC8180216 DOI: 10.12998/wjcc.v9.i16.3996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronary artery aneurysm combined with myocardial bridge is a very rare clinical situation. The prognosis of this clinical situation is not yet clear.
CASE SUMMARY A coronary artery aneurysm and myocardial bridge in the same segment of the coronary artery were found in a 54-year-old female patient who underwent coronary angiography and intravascular ultrasound examination. Through conservative treatment, the patient was discharged from the hospital smoothly, and she was in good condition during 5 mo of follow-up.
CONCLUSION Coronary artery aneurysm combined with myocardial bridge seems to have a good prognosis, but due to the rarity of this clinical situation, further research and follow-up are needed.
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Affiliation(s)
- Zhen Ye
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
- Fujian Institute of Coronary Artery Disease, Fuzhou 350001, Fujian Province, China
- Fujian Heart Medical Center, Fuzhou 350001, Fujian Province, China
| | - Xian-Feng Dong
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
- Fujian Institute of Coronary Artery Disease, Fuzhou 350001, Fujian Province, China
- Fujian Heart Medical Center, Fuzhou 350001, Fujian Province, China
| | - Yuan-Ming Yan
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
- Fujian Institute of Coronary Artery Disease, Fuzhou 350001, Fujian Province, China
- Fujian Heart Medical Center, Fuzhou 350001, Fujian Province, China
| | - Yu-Kun Luo
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
- Fujian Institute of Coronary Artery Disease, Fuzhou 350001, Fujian Province, China
- Fujian Heart Medical Center, Fuzhou 350001, Fujian Province, China
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Coronary artery aneurysm presenting as acute coronary syndrome: two case reports and a review of the literature. J Thromb Thrombolysis 2021; 52:683-688. [PMID: 33743116 DOI: 10.1007/s11239-021-02418-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 10/21/2022]
Abstract
Coronary artery aneurysm (CAA) is an uncommon coronary disease, with a reported incidence in adults ranging from 0.33 to 4.9%.It is usually considered a variant of coronary artery disease (CAD). CAA is associated with thrombus formation due to abnormal laminar flow, as well as abnormal platelet and endothelial-derived pathophysiologic factors within the CAA. CAA identified in the context of acute coronary syndrome (ACS) poses several unique management challenges. Optimal antiplatelet and anticoagulant therapy is the mainstay of therapy. Percutaneous intervention for CAA is associated with complications including distal embolization of thrombus, no-reflow phenomenon, stent malposition, dissection, and rupture. There are currently no accepted guidelines to direct the management of CAA in patients presenting with ACS. Preference for conservative vs. surgical or catheter-based management is controversial. We review the literature and report different treatment strategies for two cases with both CAA and ACS.
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Babeş EE, Babeş VV, Zdrîncă MM, Brihan I, Vicaş RM, Motorca MA, Pantea-Roşan LR, Venter AC. Multiple and giant coronary artery aneurysm - case report and a review of the literature. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY 2021; 61:551-554. [PMID: 33544808 PMCID: PMC7864292 DOI: 10.47162/rjme.61.2.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report an unusual case of a 70-year-old female patient admitted in the Department of Cardiology, Emergency County Hospital, Oradea, Romania, for unstable angina and heart failure. Coronary angiography and computed tomography revealed multiple coronary artery aneurysms, some of them giant, associated with significant coronary artery disease. Coronary artery aneurysm is a rare disease, but the frequency of diagnostic increased with the development of coronary angiography. However, very rarely coronary artery aneurysm is very large and can be termed “giant aneurysm”, and a small number of reports have been described in literature. The management and the prognosis of the disease is still controversial.
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Affiliation(s)
- Elena Emilia Babeş
- Department of Cardiology, Department of Interventional Cardiology, Emergency County Hospital, Oradea, Romania; ,
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Johnson TW, Räber L, di Mario C, Bourantas C, Jia H, Mattesini A, Gonzalo N, de la Torre Hernandez JM, Prati F, Koskinas K, Joner M, Radu MD, Erlinge D, Regar E, Kunadian V, Maehara A, Byrne RA, Capodanno D, Akasaka T, Wijns W, Mintz GS, Guagliumi G. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. Eur Heart J 2020; 40:2566-2584. [PMID: 31112213 DOI: 10.1093/eurheartj/ehz332] [Citation(s) in RCA: 197] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/16/2019] [Accepted: 05/07/2019] [Indexed: 12/29/2022] Open
Abstract
This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful imaging features to identify culprit and vulnerable coronary plaque, which offers the interventional cardiologist guidance on when to adopt an intracoronary imaging-guided approach to the treatment of coronary artery disease and provides an appraisal of intravascular imaging-derived metrics to define the haemodynamic significance of coronary lesions.
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Affiliation(s)
- Thomas W Johnson
- Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHSFT & University of Bristol, Bristol, UK
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Carlo di Mario
- Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
| | - Christos Bourantas
- Department of Cardiology, Barts Heart Centre, Barts Health NHS & Queen Mary University, London, UK
| | - Haibo Jia
- Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
| | - Alessio Mattesini
- Department of Cardiology, Barts Heart Centre, Barts Health NHS & Queen Mary University, London, UK
| | - Nieves Gonzalo
- Department of Cardiology, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Francesco Prati
- Department of Cardiology, San Giovanni Hospital, Rome, Italy & CLI Foundation Rome, Italy
| | - Konstantinos Koskinas
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Joner
- Deutsches Herzzentrum München, DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Technische Universität München, Munich, Germany
| | - Maria D Radu
- Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - David Erlinge
- Department of Cardiology, Lund University, Skane University Hospital, Lund, Sweden
| | - Evelyn Regar
- Department of Cardiovascular Surgery, Zürich University Hospital, Zürich, Switzerland
| | - Vijay Kunadian
- Institute of Cellular Medicine, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Akiko Maehara
- Cardiovascular Research Foundation, Columbia University, New York, NY, USA
| | - Robert A Byrne
- Deutsches Herzzentrum München, DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Technische Universität München, Munich, Germany
| | - Davide Capodanno
- Division of Cardiology, Cardio-Thoraco-Vascular and Transplant Department, CAST, Rodolico Hospital, AOU "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | | | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Saolta University Healthcare Group, Galway, Ireland
| | - Gary S Mintz
- Cardiovascular Research Foundation, Columbia University, New York, NY, USA
| | - Giulio Guagliumi
- Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy
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Zhu X, Zhou Q, Tong S, Zhou Y. Challenges and strategies in the management of coronary artery aneurysms. Hellenic J Cardiol 2020; 62:112-120. [PMID: 32937198 DOI: 10.1016/j.hjc.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 09/03/2020] [Indexed: 11/27/2022] Open
Abstract
Coronary artery aneurysms (CAAs) are infrequent but not rare. Because of the lack of supportive data and a substantial knowledge gap in this field, clinicians are in a dilemma how to manage patients with coronary artery aneurysms. Most often, CAAs are discovered incidentally, while symptomatic patients present with diverse complications of unstable angina, myocardial infarction, arrhythmias, or sudden cardiac death. Therapeutical approaches consist of surgical procedure, percutaneous coronary intervention (PCI), and medical management. Because of the scarcity of randomized trials or large-scale data on symptomatic and asymptomatic patients with coronary artery aneurysms, the management of these patients poses considerable challenges for the cardiologists. This review summarizes the current literature, a proposed algorithm for the management of CAAs is highlighted in the text. In view of the majority of current proposal information based on small series of case reports or observational studies, an individualized therapeutic regimen should be on the basis of the location, expansion by time, morphology, complications, and etiologies of the coronary artery aneurysms, the clinical presentations, and the patient's characteristics.
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Affiliation(s)
- Xiaogang Zhu
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China; Department of Cardiology, Fu Xing Hospital, Capital Medical University, Beijing 100038, China
| | - Quanzhong Zhou
- Department of Radiology, The Center for Medical Imaging of Guizhou Province, Affiliated Hospital of Zunyi Medical University, No. 149 Dalian Road, Huichuan District, Zunyi, Guizhou Province, 563000, China
| | - Shan Tong
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China
| | - Yujie Zhou
- Department of Cardiology, 12th Ward, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing 100029, China.
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Hernández-Mejía BI, Espinoza-Saquicela ER. Giant right coronary artery aneurysm. Case Report. CASE REPORTS 2020. [DOI: 10.15446/cr.v6n1.82446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.
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11
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Johnson TW, Räber L, Di Mario C, Bourantas CV, Jia H, Mattesini A, Gonzalo N, de la Torre Hernandez JM, Prati F, Koskinas KC, Joner M, Radu MD, Erlinge D, Regar E, Kunadian V, Maehara A, Byrne RA, Capodanno D, Akasaka T, Wijns W, Mintz GS, Guagliumi G. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. EUROINTERVENTION 2019; 15:434-451. [PMID: 31258132 DOI: 10.4244/eijy19m06_02] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful imaging features to identify culprit and vulnerable coronary plaque, which offers the interventional cardiologist guidance on when to adopt an intracoronary imaging-guided approach to the treatment of coronary artery disease and provides an appraisal of intravascular imaging-derived metrics to define the haemodynamic significance of coronary lesions.
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Affiliation(s)
- Thomas W Johnson
- Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHSFT & University of Bristol, BS2 8HW, Bristol, United Kingdom
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12
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Pernigo M, Triggiani M, Pentiricci S, Montresor G. Giant Right Coronary Artery Aneurysm Detected by Transthoracic Echocardiography. J Cardiovasc Echogr 2019; 29:29-31. [PMID: 31008037 PMCID: PMC6450233 DOI: 10.4103/jcecho.jcecho_59_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Coronary artery aneurysms (CAAs) are rare findings caused by atherosclerosis in about 50% of cases. They are usually diagnosed using coronary angiography, cardiac computed tomography, or magnetic resonance imaging. In this report, we present a rare case of giant, isolated right CAA, detected by transthoracic echocardiography in an adult patient with unstable angina. Diameters of the aneurysm were 3.6 cm × 2.7 cm. Anterior-septal hypokinesia of the left ventricle was also noted. A comprehensive echocardiographic examination, including contrast study, excluded alternative diagnoses and supported the hypothesis of a coronary ectasia. The coronary angiography confirmed the diagnosis of giant coronary aneurysm and revealed a severe three-vessel disease. The patient was treated with cardiac surgery a few days later: two coronary artery bypass grafts and exclusion of the aneurysm by surgical legation were successfully performed.
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Affiliation(s)
- Matteo Pernigo
- Division of Cardiology, "La Memoria" Hospital, Brescia, Italy
| | - Marco Triggiani
- Division of Cardiology, "La Memoria" Hospital, Brescia, Italy
| | - Samuele Pentiricci
- Division of Cardiac Surgery, "Papa Giovanni XXIII" Hospital, Bergamo, Italy
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13
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Sheikh AS, Hailan A, Kinnaird T, Choudhury A, Smith D. Coronary Artery Aneurysm: Evaluation, Prognosis, and Proposed Treatment Strategies. Heart Views 2019; 20:101-108. [PMID: 31620255 PMCID: PMC6791093 DOI: 10.4103/heartviews.heartviews_1_19] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
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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Affiliation(s)
- Azeem S Sheikh
- Department of Cardiology, University Hospital of Wales, Cardiff, UK
| | - Ahmed Hailan
- Department of Cardiology, Morriston Hospital, Swansea, UK
| | - Tim Kinnaird
- Department of Cardiology, University Hospital of Wales, Cardiff, UK
| | | | - David Smith
- Department of Cardiology, Morriston Hospital, Swansea, UK
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14
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Forte E, Aiello M, Inglese M, Infante T, Soricelli A, Tedeschi C, Salvatore M, Cavaliere C. Coronary artery aneurysms detected by computed tomography coronary angiography. Eur Heart J Cardiovasc Imaging 2018; 18:1229-1235. [PMID: 28025267 DOI: 10.1093/ehjci/jew218] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/25/2016] [Indexed: 01/11/2023] Open
Abstract
Aims Coronary artery aneurysms (CAAs) are incidentally revealed by coronary angiography and consist in a localized dilation of a coronary artery. Although invasive coronary angiography (ICA) is the gold standard imaging technique, it can lead to the underestimation of CAAs diameter in presence of parietal thrombi. Computed tomography coronary angiography (CTCA) is a very sensitive tool in CAAs detection and provides a clear visualization of coronary lumen highlighting intraluminal thrombi. Methods and results We retrospectively reviewed 390 CTCA performed at our institution, 9 patients (6 men, 3 women) resulted affected by CAAs and represented the aneurysmal group (A group). Matched controls were identified among the non-aneurysmal patients with healthy coronaries to CTCA (NAH group). Clinical variables and imaging findings were compared and correlated. CAAs prevalence in our population was 2.31%. 15 CAAs were detected, mainly on the right coronary artery (RCA) (9 aneurysms) followed by the left anterior descending coronary artery (LAD) (three aneurysms) and the left circumflex coronary artery (CX) (three aneurysms). In six patients (66.7%) CTCA displayed an aneurysmal thrombosis and in 5 patients (55.5%) CAAs were associated to coronary artery stenoses. A statistically significant difference was found between the diameters of coronary vessels measured in healthy segments in A and NAH group. Conclusions CTCA has led to a non-invasive estimation of CAAs prevalence and characterization of aneurysmal features and coronary anatomy. Overcoming ICA limitations, CTCA has provided a fine analysis of the aneurysms, also in presence of intraluminal thrombi.
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Affiliation(s)
- Ernesto Forte
- IRCCS SDN, Via E. Gianturco 113, 80143 Naples, Italy
| | - Marco Aiello
- IRCCS SDN, Via E. Gianturco 113, 80143 Naples, Italy
| | | | | | | | - Carlo Tedeschi
- Unit of Cardiology, San Gennaro Hospital, ASL Napoli 1 Centro, Via San Gennaro 25, 80100 Naples, Italy
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15
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Kawsara A, Núñez Gil IJ, Alqahtani F, Moreland J, Rihal CS, Alkhouli M. Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv 2018; 11:1211-1223. [DOI: 10.1016/j.jcin.2018.02.041] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 01/07/2018] [Accepted: 02/20/2018] [Indexed: 01/11/2023]
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16
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Abou Sherif S, Ozden Tok O, Taşköylü Ö, Goktekin O, Kilic ID. Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment. Front Cardiovasc Med 2017; 4:24. [PMID: 28529940 PMCID: PMC5418231 DOI: 10.3389/fcvm.2017.00024] [Citation(s) in RCA: 181] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/07/2017] [Indexed: 12/11/2022] Open
Abstract
Coronary artery aneurysms (CAAs) are uncommon and describe a localized dilatation of a coronary artery segment more than 1.5-fold compared with adjacent normal segments. The incidence of CAAs varies from 0.3 to 5.3%. Ever since the dawn of the interventional era, CAAs have been increasingly diagnosed on coronary angiography. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. The natural history of CAAs remains unclear; however, several recent studies have postulated the underlying molecular mechanisms of CAAs, and genome-wide association studies have revealed several genetic predispositions to CAA. Controversies persist regarding the management of CAAs, and emerging findings support the importance of an early diagnosis in patients predisposed to CAAs, such as in children with KD. This review aims to summarize the present knowledge of CAAs and collate the recent advances regarding the epidemiology, etiology, pathophysiology, diagnosis, and treatment of this disease.
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Affiliation(s)
- Sara Abou Sherif
- Cardiovascular Research Division, Kings College London, London, UK
| | - Ozge Ozden Tok
- Department of Cardiology, Memorial Hospital, Istanbul, Turkey
| | | | - Omer Goktekin
- Department of Cardiology, Memorial Hospital, Istanbul, Turkey
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17
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Naraen A, Reddy P, Notarstefano C, Kudavali M. Giant Coronary Artery Aneurysm in a Middle-Aged Woman. Ann Thorac Surg 2017; 103:e313-e315. [DOI: 10.1016/j.athoracsur.2016.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/20/2016] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
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18
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[Noninvasive imaging techniques to study coronary artery aneurysms]. RADIOLOGIA 2012; 54:357-62. [PMID: 22300967 DOI: 10.1016/j.rx.2011.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 08/31/2011] [Accepted: 09/01/2011] [Indexed: 12/17/2022]
Abstract
Given the growing evidence about the use of membrane-covered stents to treat coronary artery aneurysms, it is fundamental to know the exact anatomy of the aneurysm to enable patients to be selected correctly. Invasive heart catheterization has limitations for diagnostic purposes and can underestimate the size of the aneurysm. In this article, we review the noninvasive diagnostic imaging techniques for the study of coronary artery aneurysms, illustrating the usefulness of each technique.
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19
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Pursnani A, Jacobs JE, Saremi F, Levisman J, Makaryus AN, Capuñay C, Rogers IS, Wald C, Azmoon S, Stathopoulos IA, Srichai MB. Coronary CTA assessment of coronary anomalies. J Cardiovasc Comput Tomogr 2011; 6:48-59. [PMID: 22264632 DOI: 10.1016/j.jcct.2011.06.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Revised: 05/23/2011] [Accepted: 06/10/2011] [Indexed: 12/23/2022]
Abstract
Coronary anomalies occur in <1% of the general population and can range from a benign incidental finding to the cause of sudden cardiac death. The coronary anomalies are classified here according to the traditional grouping into those of origin and course, intrinsic arterial anatomy, and termination. Classic coronary anomalies of origin and course include those in which a coronary artery originates from the contralateral aortic sinus or the pulmonary artery with anomalous course. Single coronary artery anomalies, in which single coronary artery branches to supply the entire coronary tree, are also included in this category. Anomalies of intrinsic arterial anatomy are a broad class that includes myocardial bridges, coronary ectasia and aneurysms, subendocardial coursing arteries, and coronary artery duplication. Coronary anomalies of termination are those in which a coronary artery terminates in a fistulous connection to a great vessel or cardiac chamber. In the case of those anomalies associated with a risk of sudden cardiac death, the relevant imaging features on CT angiography (CTA) associated with poorer prognosis are reviewed. Recent guidelines and appropriateness criteria favor the use of coronary CTA for the evaluation of coronary anomalies. Although invasive angiography has historically been used to diagnose coronary anomalies, multidetector CT imaging techniques have now become an accurate noninvasive alternative. Cardiac CTA provides excellent spatial and temporal resolution, allowing accurate anatomical assessment of these anomalies.
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Affiliation(s)
- Amit Pursnani
- Temple University School of Medicine, Division of Cardiology, Pennsylvania, PA, USA
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20
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Roy SK, Kadakia J, Shittu A, Budoff MJ. Coronary artery aneurysms as seen on multidetector computed tomography angiography. Catheter Cardiovasc Interv 2011; 78:1127-32. [PMID: 21805608 DOI: 10.1002/ccd.23293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 06/25/2011] [Indexed: 11/07/2022]
Abstract
Coronary artery aneurysms (CAA) are present in 1.4-5.3% of the population (Nichols, Lagana, Parwani. Arch Pathol Lab Med 2008; 132:823-828). While angiography remains the gold standard for evaluating CAAs, multidetector computed tomography angiography (MDCTA) is an emerging way of assessing CAAs (Pahlavan and Niroomand. Clin Cardiol 2006;29:439-443). With the increasing clinical utilization of MDCTA, CAAs are often initially diagnosed using this method. Since MDCTA is used largely in lower risk and asymptomatic patients, understanding the etiology and treatment is paramount for clinicians reading these studies.
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21
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Oyama-Manabe N, Sugaya T, Yamaguchi T, Terae S. Non-coronary cardiac findings and pitfalls in coronary computed tomography angiography. J Clin Imaging Sci 2011; 1:51. [PMID: 22184544 PMCID: PMC3237007 DOI: 10.4103/2156-7514.86666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 10/03/2011] [Indexed: 11/09/2022] Open
Abstract
Non-coronary incidental findings are not rare. Kirsch et al found 67% non-coronary abnormalities with coronary computed tomography angiography (CCTA). Radiologists are expected to identify the extracoronary, intra- and para-cardiac anatomical structures and distinguish them from pathologic processes in CCTA. We have reviewed 2000 CCTA studies done at our institution with 64-MDCT. This pictorial essay presents case studies of non-atherosclerotic cardiovascular findings to recognize cardiac anatomic structures and how to distinguish them from pathologic processes. Correct interpretation of benign, clinically insignificant findings is crucial to avoid unnecessary additional imaging tests.
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Affiliation(s)
- Noriko Oyama-Manabe
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, kita-ku, Sapporo, Japan
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22
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Cho Y, Choe H, Kang BR, Park MY, Doh JH, Kwak JJ, Yoon BY, Namgung J, Lee SY, Hur G. Development of a coronary aneurysm at a sirolimus-eluting stent-implanted lesion in a patient with churg-strauss syndrome. Korean Circ J 2011; 41:559-62. [PMID: 22022335 PMCID: PMC3193051 DOI: 10.4070/kcj.2011.41.9.559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 03/22/2011] [Accepted: 03/28/2011] [Indexed: 11/11/2022] Open
Abstract
A coronary aneurysm (CA) can occur in sirolimus-eluting stent (SES)-implanted coronary lesions. Although several possible mechanisms have been suggested, the precise pathogenesis of a CA in SES-implanted lesions is still unknown. We report a patient with Churg-Strauss syndrome who underwent successful percutaneous coronary intervention with SES and then experienced a CA in an SES-implanted coronary lesion. We describe the CA characteristics through the use of coronary angiography, coronary 64-multidetector computed tomography, and intravascular ultrasound and discuss the etiological factors for the CA in this patient.
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Affiliation(s)
- Yujung Cho
- Department of Internal Medicine, Vision 21 Cardiac and Vascular Center, Ilsan Paik Hospital, Goyang, Korea
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23
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CT angiography of coronary artery aneurysms: detection, definition, causes, and treatment. AJR Am J Roentgenol 2010; 195:928-34. [PMID: 20858820 DOI: 10.2214/ajr.09.3517] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This article reviews the predisposing conditions, diagnostic criteria, CT appearances, and potential complications of coronary artery aneurysms. CONCLUSION With the increasing use of MDCT to image the coronary arteries, aneurysms will be identified more frequently. Coronary artery aneurysms arise from a variety of causes, with CT appearance, management, and clinical course depending on the cause.
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24
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Díaz-Zamudio M, Bacilio-Pérez U, Herrera-Zarza MC, Meave-González A, Alexanderson-Rosas E, Zambrana-Balta GF, Kimura-Hayama ET. Coronary artery aneurysms and ectasia: role of coronary CT angiography. Radiographics 2010; 29:1939-54. [PMID: 19926755 DOI: 10.1148/rg.297095048] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronary artery dilatations-aneurysms and ectasia-are an uncommon and frequently unrecognized incidental finding in patients with coronary artery disease. Aneurysms and ectasia are associated with a vast group of disorders, and the evaluation and characterization of coronary aneurysms and ectasia represent a great diagnostic task with clinical and therapeutic implications. The underlying etiology is variable and includes degenerative, congenital, inflammatory, infectious, toxic, and traumatic causes. Unlike aneurysms, ectasia is more frequently seen in association with atherosclerosis or as a compensatory mechanism in those cases in which a proximal stenosis is noted in the opposite coronary artery; ectasia is also seen in some coronary artery anomalies, such as anomalous origin from the pulmonary artery, or as a result of a high-flow state, as seen in coronary artery fistulas. The diagnostic approach depends on the clinical scenario, and nowadays, noninvasive evaluation with multidetector computed tomography is possible. Imaging assessment should include evaluation of (a) the distribution, (b) maximal diameter, (c) presence or absence of intraluminal thrombi, (d) number, (e) extension, and (f) associated complications such as myocardial infarction. This article presents an overview of the definition, classification, etiology, clinical manifestations, and potential complications of coronary artery aneurysms and ectasia.
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Affiliation(s)
- Mariana Díaz-Zamudio
- Department of Radiology and Imaging, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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25
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Sengupta G, Dipankar M, Das D, Lowrence J, Rai N, Kumar SD. Giant aneurysm of the right coronary artery: A case report. Indian J Thorac Cardiovasc Surg 2008. [DOI: 10.1007/s12055-008-0020-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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26
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CT and MRI of Coronary Artery Disease:Self-Assessment Module. AJR Am J Roentgenol 2006. [DOI: 10.2214/ajr.06.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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27
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Attili AK, Cascade PN. CT and MRI of coronary artery disease: evidence-based review. AJR Am J Roentgenol 2006; 187:S483-99. [PMID: 17114564 DOI: 10.2214/ajr.06.0309] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The educational objective of this evidence-based self-assessment module is to use case examples to review the current evidence and the roles of CT and MRI in evaluating and managing patients with both congenital and acquired coronary artery disease. CONCLUSION In this educational module, we review the use of CT and MRI in the noninvasive diagnosis and management of patients with coronary artery disease.
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Affiliation(s)
- Anil K Attili
- Division of Cardiothoracic Radiology, Department of Radiology, Taubman Center, 1500 E Medical Center Dr., Ann Arbor, MI 48109-0326, USA.
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28
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Chen JK, Johnson PT, Fishman EK. Detection of a fusiform coronary artery aneurysm using CT angiography. Emerg Radiol 2006; 13:99-101. [PMID: 16988808 DOI: 10.1007/s10140-006-0518-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2006] [Accepted: 06/23/2006] [Indexed: 10/24/2022]
Affiliation(s)
- Jennifer K Chen
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Vembar M, Walker MJ, Johnson PC. Cardiac imaging using multislice computed tomography scanners: technical considerations. Coron Artery Dis 2006; 17:115-23. [PMID: 16474229 DOI: 10.1097/00019501-200603000-00004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Conventional coronary angiography is currently the gold standard in the detection and diagnosis of coronary artery disease. This modality, however, is invasive in nature. Hence, there is a need for noninvasive imaging techniques to provide comprehensive assessment of coronary artery disease, especially in stable patients at low to moderate risk of disease. In recent years, a number of noninvasive modalities have found wide applications in cardiac imaging. Most recent investigations have used magnetic resonance imaging, multislice computed tomography and electron-beam computed tomography scanners. This review discusses the clinical challenges existing in the field of cardiac imaging and focuses on the technical advancements of multislice computed tomography scanners that have made them a very attractive noninvasive option for the detection and diagnosis of coronary artery disease.
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Affiliation(s)
- Mani Vembar
- Clinical Science, Computed Tomography Division, Philips Medical Systems, Cleveland, Ohio 44143, USA.
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