Author + information
- Received December 19, 2016
- Accepted December 29, 2016
- Published online March 20, 2017.
- Krysthel Engstrom, MDa,
- Asaad A. Khan, MDb,
- Gina LaRocca, MD, MHScc,
- Annapoorna S. Kini, MDd and
- Samin K. Sharma, MDe,∗ ()
- aDepartment of Cardiology, Mount Sinai Medical Center, New York, New York
- bDepartment of Interventional Cardiology, Mount Sinai Medical Center, New York, New York
- cDepartment of Advanced Cardiovascular Imaging, Mount Sinai Medical Center, New York, New York
- dDepartment of Interventional Cardiology, Mount Sinai Medical Center, New York, New York
- eDepartment of Interventional Cardiology, Mount Sinai Medical Center, New York, New York
- ↵∗Address for correspondence:
Dr. Samin K. Sharma, 1450 Madison Avenue, KCC 6th Floor, Suite 6-62, Mount Sinai Medical Center, New York, New York 10029.
A 40-year-old man presented to our facility with progressive angina 1 month after an unsuccessful attempt at right coronary artery (RCA) revascularization following a non–ST-segment elevation myocardial infarction. Coronary angiography revealed a dominant RCA with a very large aneurysm in the mid-segment that was totally occluded (Figure 1). The distal vessel was large, with mild atherosclerotic disease filling via bridging collateral vessels. Left anterior descending and circumflex coronary arteries were ectatic and large vessels.
The RCA was treated with a Synergy (Boston Scientific, Natick, Massachusetts) 4.0/38 mm stent with excellent angiographic results. Computed tomography angiography confirmed the presence of a giant aneurysm measuring 12.9 × 19 mm (Figure 2). Angiography at 6 months showed a patent stent with good distal flow and no flow into the aneurysm (Figure 3).
Covered stents have been used for percutaneous treatment of coronary aneurysms despite poor short- and long-term outcomes (1–3). In view of our patient’s age, we decided to treat the thrombosed aneurysm with a drug-eluting stent (DES). This novel use of DES in symptomatic, young patients with a coronary aneurysm and complex anatomy proved to be a successful and relatively safe approach with potentially better long-term outcomes.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 19, 2016.
- Accepted December 29, 2016.
- 2017 American College of Cardiology Foundation