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Pathophysiology, Diagnosis, and Management of Coronary Artery Aneurysms: A Review

Rengin Çetin Güvenç1, Abdullah Ayar Al Arfaj1, Hola Razouk1

  • 1Department of Cardiology, Okan University School of Medicine, 34959 Istanbul, Turkey.

Reviews in Cardiovascular Medicine
|September 10, 2025
PubMed

Insights

Coronary artery aneurysms (CAAs) are common findings in cardiac imaging. This review covers CAA causes, risks like thrombus formation and rupture, and management options from medical therapy to surgical intervention.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms (CAAs) are identified in up to 8% of patients undergoing coronary imaging.
  • Atherosclerosis-induced positive remodeling is the primary cause, though congenital, inflammatory, and traumatic factors also contribute.
  • CAAs pose risks including thrombus formation and distal embolization, with rupture being a rare but severe complication.

Purpose of the Study:

  • To provide a comprehensive overview of coronary artery aneurysms.
  • To detail nomenclature, classification, pathophysiology, and diagnostic approaches.
  • To emphasize current and emerging treatment strategies for managing CAA-related risks.

Main Methods:

  • Review of existing literature on coronary artery aneurysms.
  • Synthesis of data regarding etiology, clinical presentation, and complications.
  • Analysis of current management paradigms, including medical, percutaneous, and surgical interventions.

Main Results:

  • CAAs are frequently associated with atherosclerotic disease.
  • Thrombus formation and embolization are significant complications.
  • Management strategies are tailored based on aneurysm characteristics and patient risk factors.

Conclusions:

  • Coronary artery aneurysms require careful evaluation and management.
  • Percutaneous exclusion is suitable for aneurysms at risk of rupture or thrombosis.
  • Surgical correction is reserved for complex cases or when percutaneous options are unsuitable.

Keywords:
aneurysmcardiac surgical procedurescoronary arteriesmyocardial ischemiapercutaneous coronary intervention

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