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https://doi.org/10.15836/ccar2022.242

The role of coronary computed tomography-angiography in post-procedural assessment of the coronary artery aneurysms: a case report

Lidija Pleš orcid id orcid.org/0000-0003-2302-5852
Antun Zvonimir Kovač orcid id orcid.org/0000-0001-6276-4450
Kata Ćorić orcid id orcid.org/0000-0003-4904-0380
Petar Medaković orcid id orcid.org/0000-0002-7173-8286
Ladislav Pavić
Mladen Jukić orcid id orcid.org/0000-0002-3927-3888


Puni tekst: engleski pdf 136 Kb

str. 242-242

preuzimanja: 59

citiraj

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Sažetak

Ključne riječi

coronary artery aneurysm; coronary computed tomography angiography; post left ventricular assist device related complications

Hrčak ID:

287681

URI

https://hrcak.srce.hr/287681

Datum izdavanja:

8.12.2022.

Posjeta: 178 *



Introduction: Coronary computed tomography angiography (CCTA) is an accurate noninvasive diagnostic test for diagnosing coronary artery disease (CAD), evaluation of intracoronary stent patency and percutaneous coronary intervention (PCI) related complications. (1,2) Coronary artery aneurysm formation is one of the possible post PCI complications. (3) The aim is to present a case of coronary artery aneurysm assessed by serial (CCTA after intracoronary stent placement.

Case report: 54-year-old man with previously known CAD and low adherence to prescribed therapy that was treated with multiple PCI and intracoronary stents was referred to our hospital for a follow-up CCTA to evaluate the possibility of CAD progression and stent patency. Baseline post-PCI CCTA in 2019 revealed normal stents patency and moderate CAD with no sign of aneurysm. Among risk factors, arterial hypertension, dyslipidemia and heavy smoking was revealed with no chest symptoms. Two follow up CCTA were performed. First follow up CCTA revealed progression of CAD in proximal circumflex artery (Cx) with mild in-stent restenosis and newly outpouching of the mid Cx between two stents consistent with the formation of partially thrombosed coronary artery aneurysm (CA). CA considerably increased in diameter (9 vs 17 mm) and amount of thrombosis at the second post PCI follow up CCTA with subocclusion of distal stent.

Conclusion: CCTA serves as a guidance tool to plan interventional procedures as it allows three dimensional assessment of coronary atherosclerotic plaque features and also procedure and disease related complications.

LITERATURE

1 

Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al. ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020 January 14;41(3):407–77. https://doi.org/10.1093/eurheartj/ehz425 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31504439

2 

Andreini D, Collet C, Leipsic J, Nieman K, Bittencurt M, De Mey J, et al. Pre-procedural planning of coronary revascularization by cardiac computed tomography. J Cardiovasc Comput Tomogr. 2022 Aug 22:S1934-5925(22)00274-X. https://doi.org/10.1016/j.jcct.2022.08.003 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/36008263

3 

Gade CL, Lin F, Feldman DN, Weinsaft JW, Min JK. Assessment of coronary artery aneurysm after stent placement for myocardial infarction: evaluation by multidetector computed tomography. J Cardiovasc Comput Tomogr. 2008 March-April;2(2):117–9. https://doi.org/10.1016/j.jcct.2007.12.013 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/19083932


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