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Unmasking of a Giant Coronary Aneurysm by Chronic Total Coronary Occlusion Percutaneous Coronary Intervention

Yvemarie B O Somsen1, Sina Porouchani2, Ruben W de Winter1

  • 1Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

JACC. Case Reports
|May 10, 2024
PubMed

Insights

A giant coronary aneurysm was discovered in a young female patient during treatment for non-ST-segment elevation myocardial infarction. This finding occurred unexpectedly during a complex percutaneous coronary intervention procedure.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Non-ST-segment elevation myocardial infarction (NSTEMI) necessitates prompt diagnosis and treatment.
  • Coronary artery aneurysms are uncommon but can lead to serious complications.

Observation:

  • A young female patient presented with NSTEMI.
  • Invasive coronary angiography revealed a total occlusion of the right coronary artery.
  • Dual catheter access was employed for percutaneous coronary intervention.

Findings:

  • Retrograde tip injection and wiring during PCI unexpectedly revealed a giant coronary aneurysm.
  • Noninvasive imaging modalities confirmed the presence of the aneurysm.

Implications:

  • This case highlights the importance of considering rare underlying pathologies during complex interventional procedures.
  • Early identification and characterization of coronary aneurysms are crucial for appropriate management.
  • Advanced imaging and interventional techniques can aid in diagnosing incidental findings.

Keywords:
acute coronary syndromecomputed tomographycoronary vessel anomalyhybrid imagingpercutaneous coronary intervention

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