Topaz O, Rutherford MS, Mackey-Bojack S, Prinz AW, Katta S, Salter D, Titus JL. Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates.
Cardiovasc Pathol 2006;
14:298-302. [PMID:
16286038 DOI:
10.1016/j.carpath.2005.08.007]
[Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2005] [Revised: 07/18/2005] [Accepted: 08/08/2005] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION
Giant aneurysms that develop in native coronary arteries or saphenous vein grafts are morphologically defined as abnormally expanded outpouching vascular structures >4 cm in diameter. The location, morphology, and content of giant aneurysms account for adverse cardiovascular effects.
METHODS
Two cases of giant aneurysms were studied comprehensively by noninvasive and invasive cardiac methods and subsequent histopathology. The first patient had a giant aneurysm that developed over a course of several years in a saphenous vein graft whereas the second patient had a giant aneurysm occurring within a native coronary artery. Accompanying clinical and angiographic findings are described.
RESULTS
Atherosclerosis and thrombosis were among the prominent histopathological findings.
CONCLUSIONS
Atherosclerosis and associated thrombosis within giant aneurysms result in obstruction of flow, distal embolization, and development of acute coronary syndromes including recurrent ischemic chest pain, unstable angina, and acute myocardial infarction. The options for clinical management of giant coronary or vein graft aneurysms include surgical excision, percutaneous coil occlusion and stent deployment, or medical approach.
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