Chest stab wound-related coronary artery pseudoaneurysm sealed with a polytetrafluoroethylene-covered stent

Abstract

We describe a case in which a polytetrafluoroethylene (PTFE)-covered stent was implanted to treat impending rupture of a coronary artery pseudoaneurysm related to a chest stab wound. In this case, transthoracic echocardiography was used to verify the characteristics of the pseudoaneurysm, and we concluded that a PTFE-covered stent may prevent rupture in post-traumatic pseudoaneurysm.

Post Traumatic Pseudoaneurysm of Left Anterior Descending Artery Presenting as Acute Coronary Syndrome

“…Currently there are no evidence based guidelines on the treatment modality for coronary pseudoaneurysms due to their relative rarity. Size, morphology, location of the lesion [9], as well as surgical risk are the initial determinants of treatment modality.…”

“…We present a unique case of LAD pseudo aneurysm and stenosis presenting as acute coronary syndrome (ACS) months after the initial penetrating cardiac injury successfully managed by stenting. There are only few isolated case reports of coronary artery pseudoaneurysm following penetrating chest trauma published in English literature [7-9].…”

Fatal delayed cardiac tamponade due to rupture of micropseudoaneurysm of left anterior descending coronary artery following stab to the chest

“…Coronary pseudoaneurysm is defined as a disruption of coronary vessel wall integrity and the formation of a closed space surrounded by adjacent structures [4]. Unlike the true aneurysm with the presence of a wall containing intima, media, and adventitia, a pseudoaneurysm shows a loss of vessel wall integrity and transition from a threelayered wall to an outwardly bulging monolayer [3].…”

“…However, chest-stab-wound-related coronary pseudoaneurysms are rare, and only one case has been reported [4]. Since selective penetrating injuries to the coronary arteries are rare, accounting for less than 5% of all the penetrating cardiac injuries [9,10], coronary pseudoaneurysms caused by such injuries are even rarer.…”