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[Coronary ectasias and thrombosis]

M A Bouzid1, H Benamer2, X Halna du Fretay3

  • 1Hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Hôpital européen de Paris-la-Roseraie, 120, avenue de la République, 93300 Aubervilliers, France.

Annales De Cardiologie Et D'Angeiologie
|November 7, 2017
PubMed

Insights

Ectasias and coronary aneurysms, uncommon manifestations of coronary atherosclerosis, present unique challenges. Medical management is preferred due to complex anatomy, with revascularization reserved for acute coronary syndromes.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Atherosclerosis Research

Background:

  • Ectasias and coronary aneurysms are rare coronary artery diseases, often linked to coronary atherosclerosis in adults.
  • These conditions can coexist and are frequently associated with coronary stenosis.
  • Previous theories suggested poor prognosis due to in situ thrombosis and distal embolization from slow flow.

Purpose of the Study:

  • To evaluate clinical and angiographic characteristics of ectasias and coronary aneurysms.
  • To analyze therapeutic choices for these coronary artery lesions.
  • To review existing literature on the pathophysiology and management of coronary ectasias and aneurysms.

Main Methods:

  • Retrospective case series analysis of 47 patients with ectasias and coronary aneurysms.
  • Comprehensive review of clinical and angiographic data.
  • Literature review on coronary ectasias and aneurysms.

Main Results:

  • In situ thrombosis is not the typical pathophysiological mechanism.
  • Coronary ectasias and aneurysms represent a specific form of coronary atherosclerosis.
  • Medical treatment was indicated in 57.4% of cases; anticoagulants were rarely used (4.25%).
  • Revascularization was performed in 70.6% of acute coronary syndrome cases.
  • Complex angiographic features likely contribute to lower revascularization rates.

Conclusions:

  • Coronary ectasias and aneurysms are distinct manifestations of coronary atherosclerosis.
  • Medical management is the predominant treatment strategy.
  • Revascularization is reserved for acute coronary syndromes, with technical challenges influencing procedural rates.

Keywords:
AneurysmAngioplastie coronaireAnticoagulantAnévrysmeCoronary angioplastyCoronary ectasiaEctasie coronaireThromboseThrombosis

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