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Teaching Collection

Obliteration of a Left Main Coronary Artery Aneurysm with a PTFE-Covered Stent<br />
CATHETER TECHNIQUES FOR THE TREATMENT OF ANEURY

Maja Strozzi, MD, Alexander Ernst, MD, PhD, Ljiljana Banfic, MD
May 2002
There are many reports in the literature about coronary artery aneurysms, their incidence, pathogenesis, clinical outcome and treatment.1–3 If asymptomatic, their progression, rupture or secondary embolization are unpredictable. Some aneurysms are related to previous coronary interventions.4–6 Recently, the obliteration of a coronary aneurysm using the covered intracoronary stent was reported.7–10 Case Report. A 40-year-old woman with atypical chest discomfort was referred to our institution for coronary angiography. Three weeks earlier she had been admitted to another hospital with an anterior wall infarction complicated with heart failure. The family history was negative for coronary artery disease and no risk factors of coronary atherosclerosis were present. Coronary angiogram (Figure 1A) showed a normal right coronary artery and a saccular aneurysm of the left main coronary artery (LMCA) with
1. Swaye PS, Fisher LD, Litwin P, et al. Aneurysmal coronary artery disease. Circulation 1983;67:134–138. 2. Demopulos V, Olympios C, Fakiolas C, et al. The natural history of aneurysmal coronary artery disease. Heart 1997;78:136–141. 3. Syed M, Lesch M. Coronary artery aneurysm: A review. Prog Cardiovasc Dis 1997;40:70–84. 4. Lell E, Wehr G, Sechtem U. Delayed development of a coronary artery pseudoaneurysm after angioplasty. Cathet Cardiovasc Intervent 1999;47:186–190. 5. Bal ET, Plokker HWT, van de Berg EMJ, et al. Predictability and prognosis of PTCA-induced coronary artery aneurysm. Cathet Cardiovasc Diagn 1991;22:85–88. 6. Slota PA, Fischman DL, Savage MP, et al. Frequency and outcome of development of coronary artery aneurysm after intracoronary stent placement and angioplasty. Am J Cardiol 1997;79:1104–1106. 7. Gruberg L, Roguin A, Beyar R. Percutaneous closure of a coronary aneurysm with a vein-coated stent. Cathet Cardiovasc Diagn 1998;43:308–310. 8. Di Mario C, Inglese L, Colombo A. Treatment of a coronary aneurysm with a new polytetrafluoroethylene-coated stent: A case report. Cathet Cardiovasc Intervent 1999;46:463–465. 9. Satler LF, Muntz G. The promise of the covered stent. Cathet Cardiovasc Intervent 1999;46:466. 10. Vandergoten P, Put P, Benit E. Complete endovascular sealing of a coronary aneurysm and relief of two adjacent coronary stenoses with one single PTFE-covered stent. Acta Cardiol 2001;56:137–140. 11. Heuse RR, Woodfield S, Lopez A. Obliteration of a coronary artery aneurysm with PTFE-covered stent: Endoluminal graft for coronary disease revisited. Cathet Cardiovasc Intervent 1999;46:113–116. 12. Dralle JG, Turner C, Hsu J, Replogle RL. Coronary artery aneurysm after angioplasty and atherectomy. Ann Thorac Surg 1995;59:1030–1035. 13. Campbell PG, Hall JA, Harcombe AA, De Belder MA. The Jomed covered stent graft for coronary artery aneurysms and acute perforation: A successful device with careful deployment may not reduce restenosis. J Invas Cardiol 2000;12:272–276.

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