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Diagnosis and Management of Post-PCI Left Circumflex Coronary Artery Pseudoaneurysm

  • 0Interventional Cardiology, Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
Jacc. Case Reports +

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April 4, 2025

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April 4, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Coronary artery pseudoaneurysms (PSAs) are rare complications after percutaneous coronary intervention (PCI). This case highlights successful percutaneous closure of a large PSA using a covered stent, emphasizing precise placement and follow-up.

Area Of Science

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background

  • Coronary artery pseudoaneurysms (PSAs) are rare but serious complications following percutaneous coronary intervention (PCI).
  • PSAs can manifest weeks to years after PCI and pose a risk of rupture, necessitating prompt diagnosis.

Observation

  • A 77-year-old male developed a large left circumflex artery PSA within 30 days of PCI complicated by coronary perforation.
  • Initial perforation was managed with a covered stent, but PSA formation occurred after resuming anticoagulation for atrial fibrillation.

Findings

  • Computed tomographic angiography confirmed a large PSA adjacent to the previously placed stent.
  • Percutaneous closure with a second covered stent successfully isolated the pseudoaneurysm.

Implications

  • Precise stent placement and vessel wall apposition are critical to prevent PSA formation after PCI.
  • Vigilant follow-up is essential, especially in patients on intensive antithrombotic therapy.
  • Covered stent technology offers a viable percutaneous option for managing complex coronary artery pseudoaneurysms.

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