Chest pain due to late huge coronary pseudoaneurysm following stent implantation

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Marco Caruso1, Salvatore Evola, Khalil Fattouch

  • 1Cardiology Unit, University of Palermo, Italy. marcar@unipa.it

Internal Medicine (Tokyo, Japan)
|March 23, 2011
PubMed

Insights

A rapidly growing right coronary artery aneurysm was successfully treated with covered stents after a patient experienced persistent chest pain. This intervention led to symptom regression and managed the risk of rupture.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • A 50-year-old male presented with persistent atypical chest pain.
  • History of non ST elevation myocardial infarction treated with percutaneous coronary intervention (PCI) five months prior.
  • Previous angiography revealed slight ectasia near the right coronary artery stent.

Observation:

  • Chest CT identified a 31.5 mm hematoma of the right coronary artery.
  • Coronary angiography demonstrated a giant aneurysm proximal to the existing stent.
  • The aneurysm exhibited rapid growth, posing a significant risk of rupture.

Findings:

  • The patient underwent successful PCI using covered stents to treat the giant coronary aneurysm.
  • Post-procedural angiography confirmed stent placement and aneurysm exclusion.
  • Symptoms of chest pain showed significant regression following the intervention.

Implications:

  • Covered stents represent a viable treatment option for managing large, rapidly growing coronary artery aneurysms.
  • This case highlights the importance of vigilant monitoring and timely intervention for aneurysmal changes post-PCI.
  • Successful treatment can alleviate symptoms and mitigate the risk of life-threatening rupture in complex coronary artery disease cases.

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