A giant coronary artery aneurysm associated with multiple peripheral arterial aneurysms and an abdominal aortic aneurysm

Abstract Background Coronary artery aneurysms (CAA) are often diagnosed incidentally on coronary angiography or imaging modalities done for other reasons. ‘Giant’ CAA by definition exceeds 20 mm in diameter or four times the diameter of normal coronary artery. The management of patients with CAAs is challenging due to poorly understood mechanism, variable presentation, and lack of clear-cut societal recommendations. Though conservative management is preferred in asymptomatic patients, massive size or interval growth may make intervention necessary. Case summary We describe a case of successful coil embolization of a giant coronary aneurysm in an elderly 84-year-old male. Patient, who presented for a follow-up computed tomography angiography to evaluate a previously repaired abdominal aortic aneurysm 2 years back, was found to have interval growth of right coronary artery aneurysm from 4 cm in diameter to 7 × 8 cm in its greatest dimensions. The rationale for treatment was to prevent sudden death from continued growth and eventual rupture of aneurysm in addition to potential risk of thromboembolism and compression of adjacent structures. Discussion This case demonstrates the safe and successful use of extensive coil embolization technique to treat a ‘giant’ CAA in an elderly patient when surgical risks were prohibitive.

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Two ticking time bombs: giant coronary artery aneurysm and abdominal aortic aneurysm in the setting of urgent vascular surgery—a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa232 ◽

2020 ◽

Vol 4 (5) ◽

pp. 1-4

Author(s):

Sara Schukraft ◽

Thierry Carrel ◽

Mario Togni ◽

Adrian Attinger-Toller

Keyword(s):

Abdominal Aortic Aneurysm ◽

Coronary Artery ◽

Aortic Aneurysm ◽

Right Coronary Artery ◽

Artery Aneurysm ◽

Second Step ◽

Bypass Grafting ◽

Abdominal Aortic ◽

Risk Of Rupture ◽

The Right

Abstract Background Giant coronary artery aneurysms (CAAs) are rare and treatment strategies various, especially in the setting of a concomitant abdominal aortic aneurysm (AAA) which needs urgent repair. Case summary A 78-year-old Caucasian male was admitted for evaluation of a rapidly expanding AAA. In addition, computed tomography angiography revealed a 5 x 4 cm giant aneurysm of the right coronary artery. After interdisciplinary discussion, the patient underwent aorto-bi-iliac bypass grafting first. In a second step, CAA was successfully excluded and coronary artery bypass grafting of the right coronary artery was performed. Discussion Treatment strategy of CAA and timing of non-cardiac surgery is challenging. In order to minimize the overall risk of rupture interdisciplinary discussion is crucial. In our case, aorto-bi-iliac bypass grafting was safely performed, and the patient underwent successful CAA excision in a second step.

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A rare case of giant coronary artery aneurysm in the context of multiple arterial aneurysms

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2012.03.023 ◽

2012 ◽

Vol 3 (7) ◽

pp. 311-313 ◽

Cited By ~ 4

Author(s):

Andriy Solodkyy ◽

Joseph Shalhoub ◽

Govind Chetty ◽

Norman P. Briffa

Keyword(s):

Coronary Artery ◽

Rare Case ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Giant Coronary Artery Aneurysm ◽

Arterial Aneurysms

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An uncommon case of arterial aneurysms association with high plasma levels of Matrix Metalloproteinase-9 and Neutrophil Gelatinase-Associated Lipocalin

Open Medicine ◽

10.1515/med-2015-0083 ◽

2015 ◽

Vol 10 (1) ◽

Author(s):

Giovanni De Caridi ◽

Mafalda Massara ◽

Francesco Spinelli ◽

Raffaele Grande ◽

Lucia Butrico ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Axillary Artery ◽

Artery Aneurysm ◽

High Plasma ◽

Aneurysm Rupture ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Abdominal Aortic ◽

Neutrophil Gelatinase ◽

Arterial Aneurysms

Abstract The association of an axillary artery aneurysm and an abdominal aortic aneurysm is extremely rare. In this study, we describe this association in a 69 year-old-man. We measured this patient’s metalloproteinases (MMPs) and Neutrophil Gelatinase - Associated Lipocalin (NGAL) levels over a three years period before the abdominal aortic aneurysm rupture. We speculate that high serium levels of MMPs and NGAL may have a prognostic role and may predict aneurysm rupture in patients with an uncommon association of arterial aneurysms.

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