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Coronary Artery Ectasia Presenting as ST-Elevation Myocardial Infarction: An Intravascular Ultrasound-Guided

Qianfeng Xiong1, Shaoyong Chen1, Wenbo Li1

  • 1Department of Cardiology, Fengcheng People's Hospital, The Affiliated Fengcheng Hospital of Yichun University, 331100 Fengcheng, Jiangxi, China.

Reviews in Cardiovascular Medicine
|April 2, 2026
PubMed

Insights

Coronary artery ectasia (CAE) involves abnormal coronary vessel dilation. Optimal management remains controversial due to limited evidence, with current options including medical therapy, PCI, and surgery.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Interventional Cardiology

Background:

  • Coronary artery ectasia (CAE) is defined by abnormal coronary artery dilation.
  • While often linked to atherosclerosis, its pathogenesis is unclear, complicating treatment strategies.
  • Evidence from high-quality trials is lacking, leading to controversial management approaches.

Purpose of the Study:

  • To systematically review the clinical and angiographic features of CAE.
  • To discuss contemporary treatment strategies for CAE.
  • To highlight management nuances, including antithrombotic therapy and intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI).

Main Methods:

  • Literature review of coronary artery ectasia.
  • Case presentation of ST-elevation myocardial infarction (STEMI) in a patient with CAE.
  • Discussion of current therapeutic modalities: medical, PCI, and surgical.

Main Results:

  • CAE presents with diverse clinical and angiographic characteristics.
  • Optimal antithrombotic strategies require careful consideration in CAE patients.
  • Intravascular ultrasound (IVUS) may play a role in guiding PCI for CAE.

Conclusions:

  • CAE is an increasingly recognized condition with unclear pathogenesis and controversial management.
  • A comprehensive approach integrating medical therapy, PCI, and surgical considerations is necessary.
  • Further research is needed to establish evidence-based guidelines for CAE management.

Keywords:
ST elevation myocardial infarctionanticoagulantscoronary aneurysmdrug-eluting stentsinterventionalpercutaneous coronary interventionultrasonography

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