Angiographic and intravascular ultrasound characteristics of coronary artery aneurysmal lesions
10.3969/j.issn.1004-8812.2018.04.004
- VernacularTitle:冠状动脉瘤样病变的冠状动脉造影及血管内超声特点分析
- Author:
Quan YANG
1
;
Cheng-Zhi LU
;
Yun-Peng TIAN
Author Information
1. 北京大学国际医院心血管内科
- Keywords:
Coronary artery aneurysm;
Percutaneous coronary intervention;
Intravascular ultrasound
- From:
Chinese Journal of Interventional Cardiology
2018;26(4):204-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the angiographic and intravascular ultrasound(IVUS) characteristics of 65 coronary artery aneurismal lesions and to evaluate the effects of interventional and medical therapy. Methods 65 in-hosptal patients with coronary artery aneurysmal lesions with both quantitive coronary angiography and IVUS data from 10/2007 to 10/2014 were retrospectively analyzed in our center. Aneurysmal lesions were confi rmed as ture coronary artery aneurysms(CAA) (n=32)or false aneurysms(n=33)by IVUS. The angiography and IVUS characteristics in both groups were analyzed. Patients with aneurysmal lesion were provided with interventional or medical therapy according to the severety of stenosis. The major adverse cardiac events(MACE) were observed in these patients for two years. Results LAD and RCA were the most common sites of true CAA lesions(40.6% and 34.4% respectively).Compared with the false aneurysm group, the ture aneurysm group had longer aneurysm[(11.1±5.8)mm vs.(5.9±2.7)mm,P<0.001], more bifurcation vessels(21 cases vs. 8 cases,P=0.001),bigger luminal external elastic membrane[(25.6 ±10.7)mm2vs.(17.7±6.6)mm2,P=0.001],bigger luminal diameters [(6.2±1.5)mm vs.(5.3±1.0)mm,P=0.005]and bigger cross sectional area[(33.5±12.0)mm2vs. (25.8±7.9)mm2, P=0.003]. The false aneurysms group had bigger plaque burdens than the ture aneurysms[(32.4±10.7)% vs.(23.0±9.8)%,P=0.001].The ratios of receiving percutaneous coronary intervention(PCI) and medical therapy were the same in the two groups (P=0.272). The percentage receiving crossover stenting was higher in the false aneurysms group(33.3% vs. 6.2%, P=0.006). There were no cardiac death and acute myocardial infarction in both groups.One subacute in-stent thrombosis happened in the ture aneurysm group. Conclusions IVUS is a good method for diff erentiation of CAA from false coronary aneurysm. Most aneurysms were adjacent to severe stenosis and vessel bifurcation. It implied that maybe the changes of flow hemodynamics were related to the formation of coronary artery aneurysm. Sufficient and long term anti-thrombotic therapy and provisional interventions to aneurysmal unilateral severe stenosis may be a good choice of treatment for CAA.
