Coronary Artery Aneurysms After Drug-Eluting Stent Implantation
Jiro Aoki, MD, PhD,
Ajay Kirtane, MD, SM,
Martin B. Leon, MD, FACC,
George Dangas, MD, PhD, FACC*
Columbia University Medical Center, the Cardiovascular Research Foundation, New York, New York.
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Figure 1 Angiographic and IVUS Images of Coronary Artery Aneurysm
(A and B) Coronary artery aneurysm detected by coronary angiography and intravascular ultrasound (IVUS) at 8 months after bare-metal stent implantation. (C and D) Coronary artery aneurysm detected with coronary angiography and IVUS at 3 months after drug-eluting stent implantation.
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Figure 2 Angiographic and CTA Images of Coronary Artery Aneurysm After DES Implantation
Coronary artery aneurysm at 18 months after drug-eluting stent (DES) implantation. Adapted from Degertekin et al. (22). CTA = computed tomography angiography.
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Figure 3 Odds Ratios and Their 95% CIs of Coronary Artery Aneurysm Associated With DES Versus BMS
The odds ratios are shown on a logarithmic scale. The size of the square is proportional to the weight of the individual studies, measured as the inverse of the variance in the study by the Mantel-Haenszel procedure. BMS = bare-metal stent; CI = confidence interval; DES = drug-eluting stent; MR = moderate release; SIRIUS = SIRolImUS-coated Bx Velocity balloon expandable stent in the treatment of patients with de novo coronary artery lesions; SR = slow release.
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Figure 4 Proposed Treatment Algorithm
Proposed algorithm for the treatment of coronary aneurysm after DES implantation. *More than and equal to twice as large as the reference vessel diameter; **Less than twice as large as the reference vessel diameter. CABG = coronary artery bypass grafting; CT = computed tomography; IVUS = intravascular ultrasound; other abbreviations as in Figure 3.
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