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Extensive coil embolization of a giant coronary artery aneurysm in an octogenarian: a case report

Talha Ahmed1, Diljon Chahal2, Melsjan Shkullaku2

  • 1University of Maryland Midtown Campus, 827 Linden Avenue, Baltimore, MD 21209, USA.

European Heart Journal. Case Reports
|July 4, 2020
PubMed

Insights

Giant coronary artery aneurysms (CAA) can be safely treated with coil embolization, especially in elderly patients. This minimally invasive approach offers a viable alternative when surgery poses high risks, preventing potential rupture and complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms (CAA) are often incidental findings, with 'giant' CAAs exceeding 20 mm.
  • Management is challenging due to unknown mechanisms, varied presentations, and limited guidelines.
  • Conservative management is typical for asymptomatic cases, but intervention may be needed for large or growing aneurysms.

Observation:

  • A case of a giant right coronary artery aneurysm (7 x 8 cm) with interval growth was observed in an 84-year-old male.
  • The patient was undergoing follow-up for a repaired abdominal aortic aneurysm.
  • The aneurysm's rapid growth posed risks of rupture, thromboembolism, and compression of adjacent structures.

Findings:

  • Successful coil embolization of the giant coronary artery aneurysm was performed.
  • This technique was chosen due to prohibitive surgical risks in the elderly patient.
  • The procedure was safe and effective in managing the large aneurysm.

Implications:

  • Coil embolization is a safe and effective treatment for giant coronary artery aneurysms in high-risk elderly patients.
  • This minimally invasive approach can prevent life-threatening complications such as rupture.
  • The findings support coil embolization as a valuable therapeutic option when surgical intervention is not feasible.
Abstract

Keywords:
Case reportCoil embolizationComputed tomography angiogram (CTA)Coronary artery aneurysms (CAA)

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