J Med Life Sci.  2023 Sep;20(3):131-134. 10.22730/jmls.2023.20.3.131.

Spontaneous resolution of new coronary artery aneurysm following guideline-directed medical therapy after drug-eluting stent implantation

• Lee JG
• Boo KY

• KMID: 2561940
• DOI: http://doi.org/10.22730/jmls.2023.20.3.131

Abstract

Here, we present a case of a 56-year-old man with acute myocardial infarction. The patient underwent percutaneous coronary intervention (PCI) at the left main bifurcation and mid-left anterior descending artery using drugeluting stents. Four months after the PCI, the patient was readmitted for cardiac arrest. Coronary angiography (CAG) revealed stent thrombosis in the left main-toproximal left anterior descending artery and in-stent restenosis in the left main-toproximal left circumflex artery. We performed balloon angioplasty at the left main to mid-left anterior descending artery and left main to proximal left circumflex artery stents; subsequently, blood flow was fully restored. However, contrast agent extravasation was observed outside the mid-portion of the left main artery to the proximal left anterior descending artery stent, indicating the presence of a coronary artery aneurysm (CAA) outside the stent. After guideline-directed medical therapy with dual antiplatelet agents and high-intensity statins, follow-up CAG revealed near-resolution of the CAA, absence of stenotic lesions, and good blood flow.

Keyword

Aneurysm; Myocardial infarction; Percutaneous coronary intervention