Stent implantation for coronary aneurysm with edge stenosis: angiographic and intravascular analysis

The incidence of coronary artery aneurysms is about 1 to 2%, with clinical course dependent on the size of the aneurysm. A case of moderate-size aneurysm in the proximal left anterior descending coronary artery with stenosis at both edges is presented. This was interrogated with intravascular ultrasound (IVUS), and based on the patient's presentation, a single stent, size-matched 1:1 to the proximal reference, was placed across the aneurysm and both lesions. Post-implantation IVUS demonstrated residual stenosis and minimal change in the neck size of the aneurysm. At 4 months, there was no thrombosis or in-stent restenosis, and the aneurysm was almost completely resolved.