Korean Circ J.  2012 Aug;42(8):558-561. 10.4070/kcj.2012.42.8.558.

Rupture and Spontaneous Sealing of a Coronary Aneurysm After Deployment of Drug-Eluting Stent

• Kwon TJ
• Hwang JY
• Kwak CH
• Jeong YH
• Park YW
• Hwang SJ
• Park JR
• Ahn JH
• Min JH

• KMID: 2225006
• DOI: http://doi.org/10.4070/kcj.2012.42.8.558

Abstract

Lesions with coronary artery aneurysm (CAA) can become complicated during percutaneous coronary intervention. Here, we report a case of a 78-year-old man who developed a rupture, and spontaneous sealing of the CAA occurred after stent implantation, as shown by computed tomography coronary angiography.

Keyword

Coronary aneurysm; Drug-eluting stents

MeSH Terms

Aged
Aneurysm
Congenital Abnormalities
Coronary Aneurysm
Coronary Angiography
Coronary Vessels
Drug-Eluting Stents
Ear
Humans
Percutaneous Coronary Intervention
Rupture
Stents
Congenital Abnormalities
Ear

Figure

• 

  Fig. 1 Baseline three-dimensional reconstruction image of computed tomography coronary angiography. A three-dimensional reconstruction image of multidetector computed tomography coronary angiography shows a 2.5×2.5 mm saccular coronary aneurysm (black arrow) and tubular stenosis (60-70%) on the proximal right coronary artery.

• 

  Fig. 2 Coronary angiography of the right coronary artery. A: coronary angiography shows a saccular coronary artery aneurysm (large arrow) with diffuse, concentric stenosis in the proximal portion of the RCA (arrowhead). After stenting, the coronary aneurysm was no longer seen, and 1 side branch of the proximal RCA was jailed (arrow). B: angiography shows thrombolysis in myocardial infarction 3 flow and no luminal defect. C: after adjunctive ballooning, the thrombus is visualized inside the stent by the lack of contrast filling (arrow). D: balloon dilatation is performed at the site of the thrombus. E: after a second stent deployment, any filling defect suggestive of thrombus formation disappeared and good angiographic results were observed. RCA: right coronary artery.

• 

  Fig. 3 Intravacular ultrasound image. A: intravascular ultrasonography shows 2.5×2.5 mm sized small aneurysms (arrows) and fibro-fatty plaque in the proximal right coronary artery. B: after stenting, the intravascular ultrasound image shows a thrombus inside the stent (arrows), but no aneurysms were seen.

• 

  Fig. 4 CT coronary angiography after coronary intervention. CT coronary angiography 10 days after coronary intervention shows a ruptured and sealed coronary aneurysm along the proximal right coronary artery (arrow).

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