Clin Res Cardiol

2006

DOI: 10.1007/s00392-006-0453-0

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Surgical treatment of multiple atherosclerotic coronary artery aneurysms in a patient presenting with acute myocardial infarction

¹

,

Torsten Bossert

²

,

Holger H. Sigusch

³

et al.

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Clinical Course and Treatment Of Cae1

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Cited by 6 publications

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“…Coronary artery bypass grafting has been used for many years for the treatment of significant CAD co-existing with ectatic coronary segments. The presence of thrombus within the CAE and the question of the necessity to remove large aneurysms have led to the introduction of a variety of operative procedures, including proximal and distal ligation, aneurysmorrhectomy and even aneurysm resection [ 1 , 92 ]. The post-operative outcome, however, was uniformly good [ 37 ].…”

Section: Clinical Course and Treatment Of Caementioning

confidence: 99%

Novel insights into an old controversy

¹

,

²

2007

Clin Res Cardiol

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Coronary artery ectasia (CAE) is defined as a localized or diffuse non-obstructive lesion of the epicardial coronary arteries with a luminal dilation exceeding 1.5-fold the diameter of the normal adjacent arterial segment. The incidence of CAE has been reported to range between 2% and 4%, which might be an overestimation of the true frequency. The coincidence of CAE with other systemic vascular dilatations has suggested that the mechanism underlying CAE is not only localized to coronary arteries, but also to other vascular compartments such as aorta or peripheral veins. Although the pathophysiology of CAE remains largely unknown, it was supposed to represent a variant of coronary atherosclerosis. This review focuses on this controversy of whether CAE and coronary artery disease (CAD) are two manifestations of the same underlying process. There are clear differences between CAD and CAE with respect to cardiovascular risk factors such as diabetes mellitus, and pathogenic steps in disease progress such as inflammation or extracellular matrix remodeling. As this review will underscore, the current knowledge of the field is insufficient to finally clarify the causative interrelation between CAE and CAD. The clinical course and treatment of CAE mainly depends on its coexistence with CAD. When coexisting with CAD, the prognosis and treatment of CAE are the same as for CAD alone. In isolated CAE, prognosis is better and anti-platelet drugs are the mainstay of treatment. Surgical treatment can be considered in selected patients. For clarifying the mechanism underlying CAE, additional clinical, histopathological and pathophysiological investigations are required. In fact, every patient with CAE should be evaluated systematically for pathological changes in other vascular territories, both in the arterial system as well as in the venous system, which might occur in the disease process.

“…Coronary artery bypass grafting has been used for many years for the treatment of significant CAD co-existing with ectatic coronary segments. The presence of thrombus within the CAE and the question of the necessity to remove large aneurysms have led to the introduction of a variety of operative procedures, including proximal and distal ligation, aneurysmorrhectomy and even aneurysm resection [ 1 , 92 ]. The post-operative outcome, however, was uniformly good [ 37 ].…”

Section: Clinical Course and Treatment Of Caementioning

confidence: 99%

Novel insights into an old controversy

¹

,

²

2007

Clin Res Cardiol

View full text Add to dashboard Cite

Coronary artery ectasia (CAE) is defined as a localized or diffuse non-obstructive lesion of the epicardial coronary arteries with a luminal dilation exceeding 1.5-fold the diameter of the normal adjacent arterial segment. The incidence of CAE has been reported to range between 2% and 4%, which might be an overestimation of the true frequency. The coincidence of CAE with other systemic vascular dilatations has suggested that the mechanism underlying CAE is not only localized to coronary arteries, but also to other vascular compartments such as aorta or peripheral veins. Although the pathophysiology of CAE remains largely unknown, it was supposed to represent a variant of coronary atherosclerosis. This review focuses on this controversy of whether CAE and coronary artery disease (CAD) are two manifestations of the same underlying process. There are clear differences between CAD and CAE with respect to cardiovascular risk factors such as diabetes mellitus, and pathogenic steps in disease progress such as inflammation or extracellular matrix remodeling. As this review will underscore, the current knowledge of the field is insufficient to finally clarify the causative interrelation between CAE and CAD. The clinical course and treatment of CAE mainly depends on its coexistence with CAD. When coexisting with CAD, the prognosis and treatment of CAE are the same as for CAD alone. In isolated CAE, prognosis is better and anti-platelet drugs are the mainstay of treatment. Surgical treatment can be considered in selected patients. For clarifying the mechanism underlying CAE, additional clinical, histopathological and pathophysiological investigations are required. In fact, every patient with CAE should be evaluated systematically for pathological changes in other vascular territories, both in the arterial system as well as in the venous system, which might occur in the disease process.

“…ECG at 2nd presentation showing 'Q' wave in leads II, III and aVF with mild ST segment elevation and 'T' wave inversions with upsloping ST segment depression in V1-6 (panel b) appropriate. Though aneurysmal ligation and CABG are the most common techniques used, Aboud et al [5] proposed a reconstruction of the coronary artery following the clipping of the aneurysmal segment.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic Large Coronary Artery Aneurysm of the Right Coronary Artery

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,

²

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³

et al. 2019

SN Compr. Clin. Med.

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“…Considering that thrombus formation and distal embolization play crucial roles in pathogenesis of CEA [5,[11][12][13], anticoagulation and antiplatelet therapy should be beneficial to reduce cardiovascular events. In case series of Rath [14], 5 patients without obstructive coronary aneurysms developed acute myocardial infarction and complete occlusion of aneurysmal vessels without any anticoagulation and antiplatelet medications.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and coronary features of coronary ectasia and aneurysm in China

Liu²,

et al. 2013

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Objective: To describe the clinical characteristics and coronary features of patients with coronary ectasia and aneurysm (CEA) in China. Methods: This was a single center, retrospective clinical study. Patients with CEA who diagnosed by coronary artery angiography (CAG) from April 2003 to October 2009, were enrolled. All patients were followed up by the call or clinic visit. The primary outcome was all-cause mortality or cardiovascular readmission. Results: A total of 39 patients (27 males, mean age 59.5 ± 12.6 years) diagnosed with CEA, with a prevalence of 0.6% (a total of 6130 patients underwent CAG during the same period). Thirty-six patients constituted the study population, due to 3 patients lost of followup. The median follow-up was 27 months (1 -76). The single vessel was involved in 11 patients (31%), two vessels were involved in 14 patients (38%) and three or more vessels were involved in 11 patients (31%). The most common involved vessel was left anterior descending branch (n = 27), followed by right coronary artery (n = 23), left circumflex branch (n = 20) and left main branch (n = 9). There was no death during the follow-up. The primary outcome was observed in 8 (22%) patients. The use of clopidogrel and statins were associated with lower rate of cardiovascular readmission. Conclusion The incidence of CEA was low among patients who referred for CAG in China. The majority of patients had the involvement of multiple vessels, and left anterior descending branch was the most common involved vessel. The CEA patients may benefit from clopidogrel and statins.

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