“Floating” Stent in a Coronary Aneurysm Presenting as ST-Elevation Myocardial Infarction

Abstract

Coronary artery aneurysm (CAA) presenting as an ST-elevation myocardial infarction (STEMI) represents a clinical challenge due to the technical difficulties in the percutaneous management of this specific situation. Appropriate treatment for CAA depends on the precise clinical situation and consists of medical management, surgical resection, or/and stent placement. The high rate of complications during percutaneous intervention (distal thrombus embolization, no-reflow phenomenon, stent malposition, or dissection) makes emergent surgery a frequent situation in these cases. We present the case of a 50-year-old man with a STEMI due to thrombotic occlusion of CAA. Specific angiographic techniques and intracoronary imaging help with the percutaneous management of acute thrombotic occlusions in CAA, providing a less invasive approach than emergent surgery.

A Young Patient With Acute Ostial Right Coronary Artery Aneurysm Presenting As ST Elevation Myocardial Infarction

“…KD is responsible for 20% of untreated cases in children, whereas 90% of adult cases are caused by atherosclerosis [ 4 , 5 ]. CAAs can affect any of the coronary arteries; however, the incidence of left main stem CAA affects only 0.1% of the population [ 6 , 7 ]. Managing patients presenting with STEMI secondary to CAA using primary coronary angioplasty can be challenging.…”