Percutaneous exclusion of a rapidly enlarging left main coronary artery aneurysm using coils and an Amplatzer™ septal
Vikas Aggarwal1, Gregory Mishkel2, Nilesh Goswami3
1Prairie Heart Institute, St. John's Hospital, Springfield, IL.
Insights
Coronary artery aneurysms (CAAs) can cause serious complications. This case report details a successful percutaneous coil embolization treatment for a rapidly enlarging left main CAA, offering a new therapeutic approach.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Coronary artery aneurysms (CAAs) are increasingly identified, often incidentally.
- While typically managed conservatively, larger CAAs pose risks of thrombus and distal embolization.
- Limited therapeutic guidelines exist for CAA management.
Observation:
- A unique case of a rapidly enlarging left main coronary artery aneurysm (CAA) without a clear cause.
- The patient presented with potential risks of obstruction despite no significant stenosis.
Findings:
- Successful percutaneous exclusion of the left main CAA using coil embolization.
- An Amplatzer™ septal occluder device was employed in the procedure.
- The intervention effectively excluded the aneurysm, preventing further enlargement or complications.
Implications:
- This case demonstrates the feasibility and potential success of percutaneous coil embolization for treating complex CAAs.
- Highlights a viable alternative to conservative management for rapidly enlarging or symptomatic CAAs.
- Suggests a need for further research into interventional strategies for CAA treatment.
Abstract:
Coronary artery aneurysms (CAAs) are often an incidental finding amongst patients undergoing coronary angiography. Most CAAs are managed conservatively; rarely a larger CAA can lead to intramural thrombus formation and coronary artery embolization/obstruction even without the presence of significant stenosis. Despite these clinical implications, therapeutic options are limited to case reports and no clearly defined guidelines have been established for treatment. In this article, we present a unique case of a rapidly enlarging left main CAA, with no identifiable etiology that was treated with percutaneous exclusion via coil embolization and an Amplatzer™ septal occluder device. We also discuss existing literature, pathophysiology, and management options for CAAs. © 2016 Wiley Periodicals, Inc.
