Clinical outcomes of patients with coronary artery aneurysm after the first generation drug‐eluting stent implantation

Joo, Hyung Joon; Yu, Cheol Woong; Choi, Rak Kyeong; Park, Jinsik; Lee, Hyun Jong; Kim, Je Sang; Choi, Young Jin; Park, Jae Hyoung; Hong, Soon Jun; Lim, Do Sun

doi:10.1002/ccd.27429

Cited by 20 publications

(21 citation statements)

References 29 publications

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“…In our study, we documented incidence rates of CAAs after second-generation DES implantation of 0.80% per lesion and 1.02% per patient. According to previous reports on first-generation DESs, CAAs were detected with an incidence of 0.8% to 1.3% 1234. Such numbers are relatively comparable to those regarding CAAs after second-generation DES use.…”

Section: Discussionsupporting

confidence: 67%

“…Other factors for the development of CAAs have also been proposed due to DES implantation 1234. DESs have been used for reducing restenosis by administration of cytotoxic anti-restenosis drugs to inhibit endothelial cell and smooth muscle cell proliferation, and these antiproliferative effects have been suggested to increase the risk of CAAs because of the mechanism of delayed neointimal healing and reendotheliazation 1213.…”

Section: Discussionmentioning

confidence: 99%

“…The onset of coronary artery aneurysm (CAA) after drug-eluting stent (DES) implantation is uncommon, with an incidence ranging from 0.8% to 1.3%. However, associated adverse clinical events may present as a result of DES thrombosis and restenosis 1234. Furthermore, the occurrence of DES thrombosis appears to be particularly high in patients with CAA who discontinued dual-antiplatelet therapy 4.…”

Section: Introductionmentioning

confidence: 99%

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Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation

et al. 2019

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Purpose We evaluated the incidence, predictors, and prognosis of coronary artery aneurysm (CAA) after second-generation drug-eluting stent (DES) implantation. Materials and Methods A total of 976 consecutive patients (1245 lesions) who underwent follow-up angiography after second-generation DES implantation were analyzed. Incidence and predictors of CAA were assessed, and clinical prognosis was compared with 34 cases of CAA after first-generation DES implantation using previous CAA registry data. Results All 10 cases of CAA (0.80% per lesion) in 10 patients (1.02% per patient) were detected at follow up. Compared to lesions without CAA, those with CAA had greater involvement of the proximal segment (90% vs. 51%, p =0.014), a higher proportion of pre-intervention, a Thrombolysis in Myocardial Infarction score of 0 or 1 flow (80% vs. 16%, p <0.001), more chronic total occlusions (40% vs. 10%, p <0.001), and longer implanted stents (41.9±23.2 mm vs. 28.8±14.8 mm, p =0.006). As for CAA morphology, instances of CAA after second-generation DES were predominantly the single fusiform type (90%), whereas instances of CAA after first-generation DES were multiple saccular (47%) and single saccular (35%) types ( p <0.001). Myocardial infarction with stent thrombosis occurred in 5 patients with CAA after first-generation DES (15%), and no adverse events were observed in patients with CAA after second-generation DES over a median follow-up duration of 4.3 years ( p =0.047, log-rank). Conclusion Although CAAs after second-generation DES implantation were detected at a similar incidence to that for CAAs after first-generation DES implantation, second-generation DES-related CAAs had different morphologies and more benign clinical outcomes versus first-generation DES-related CAAs.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation

et al. 2019

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“…Nitrates, on the other hand, should be avoided as they were shown to increase exercise-induced angina [ 10 ]. If refractory symptoms persist despite medical therapy, percutaneous coronary intervention can be attempted; however, it is challenging, as it is associated with lower procedural success, higher rates of stent thrombosis, and repeat revascularization [ 4 , 11 - 13 ]. Surgical options have demonstrated good outcomes in patients who fail medical and percutaneous management [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Uncommon Anatomic Predisposition to Myocardial Infarction: A Case of Coronary Artery Ectasia

Ghazzal¹,

Ali²,

Radwan³

et al. 2020

Cureus

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Coronary artery ectasia (CAE) is a recognized cause of acute coronary syndrome (ACS), and can be associated with life-threatening complications, including thrombus formation with consequent distal coronary artery embolization. Several studies have demonstrated a higher incidence of cardiovascular adverse events and cardiac death in patients with CAE or coronary artery aneurysms compared to those without such abnormalities. Management of symptomatic CAE is similar to coronary artery disease (CAD), where guideline-directed medical therapy is indicated due to coexistence of CAD with acquired CAE. Percutaneous coronary intervention can be attempted; however, it is challenging, as it is associated with lower procedural success, higher rates of stent thrombosis, and repeat revascularization.

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“…Клинические проявления и прогноз АКА обычно зависят от заболевания, непосредственно приведшего к их возникновению. У больных с атеросклеротическим генезом аневризм наиболее частым симптомом является стенокардия [7][8][9], встречающаяся, впрочем, и при АКА, ассоциированных с другой патологией. В литературе описаны крайне редкие случаи одышки, сдавления прилежащих структур (правые отделы сердца, нижняя полая вена, пищевод и т.д.…”

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Клинический Случай Гигантской Аневризмы Правой Коронарной Артерии

Комаров¹,

Fedotkina²,

Меркулов³

et al. 2019

Kardiologicheskii Vestnik

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Представлен клинический разбор больного с ишемической болезнью сердца, многососудистым поражением коронарного русла и гигантской аневризмой коронарной артерии. Рассмотрены возможные подходы к выбору медикаментозного и инвазивного лечения.There was presented a clinical discussion of the patient with coronary heart disease, multivessel coronary artery disease and huge aneurysm of coronary artery. Potential approaches to selecting conservative and invasive treatment were discussed.

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Clinical outcomes of patients with coronary artery aneurysm after the first generation drug‐eluting stent implantation

Abstract: The incidence of MACE was higher in patients with CAA compared with patients without CAA after DES implantation. This difference was driven by TLR and nonfatal MI and widened over time.

Cited by 20 publications

References 29 publications

Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation

Coronary Artery Aneurysm after Second-Generation Drug-Eluting Stent Implantation

Uncommon Anatomic Predisposition to Myocardial Infarction: A Case of Coronary Artery Ectasia

Клинический Случай Гигантской Аневризмы Правой Коронарной Артерии

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