DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160830

Acute coronary syndrome with unusual form of right coronary artery aneurysm and treated with overlapping two covered stents across coronary aneurysm: case report

Naresh Sen, Keum Soo Park

Abstract


A 27-year old male presented with acute inferior wall myocardial infarction. Coronary angiogram revealed normal left coronary arteries and a giant coronary aneurysm in Right coronary artery (RCA). Primary angioplasty of RCA was performed. Large thrombus burden was retrieved with aspiration device and coronary flow restored. However, despite best efforts some thrombus remained and decision to stent was deferred to a later date. Dimensions of aneurysm on quantitative coronary angiogram were 16 mm in width and 43 mm in length. Two weeks later coronary angiogram revealed normal flow in RCA without any angiographically visible thrombus. PCI was performed with two 3.0 × 28 mm covered stents, graft master (JoStent) deployed across the aneurysm, overlapping each other. This completely sealed the aneurysm and intravascular ultrasound confirmed no leakage through the covered stents. Patient remains asymptomatic 2 months post procedure on triple antiplatelet therapy.


Keywords


Acute coronary syndrome, Right coronary artery aneurysm, Covered stent

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References


Kato H, Sugimura T, Akagi T, Sato N, Hashino K, Maeno Y, et al. Long-term consequences of Kawasaki disease: a 10- to 21-year follow-up study of 594 patients. Circulation. 1996;94:1379-85.

Syed M, Lesch M. Coronary artery aneurysm: a review. Prog Cardiovasc Dis.1997;40:77-84.

Indolfi C, Achille F, Tagliamonte G, Spaccarotella C, Mongiardo A, Ferraro A. Polytetrafluoroethylene stent deployment for a left anterior descending coronary aneurysm complicated by late acute anterior myocardial infarction. Circulation. 2005;112: e70-71.

Kanamitsu H, Yoshitaka H, Kuinose M, Tsushima Y. Giant right coronary artery aneurysm complicated by acute myocardial infarction. Gen Thorac Cardivasc Surg. 2010;58:186-9.

Takano M, Yamamoto M, Inami S, Xie Y, Murkami D, Okamatsu K, et al. Delayed endothelialization after polytetrafluoroethylene-covered stent implantation for coronary aneurysm. Circ J. 2009;73:190-3.

Lima B, Varma SK, Lowe JE. Nonsurgical management of left main coronary artery aneurysms: report of 2 cases and review of the literature. Tex Heart Inst J. 2006;33(3):376-9.

Robinson FC. Aneurysms of the coronary arteries. Am Heart J. 1985;109(1):129-35.