PCI Complications: Pseudoaneurysm

Editors-In-Chief: Alexandra Almonacid M.D. and Jeffrey J. Popma M.D.

Definition
Coronary artery aneurysm is considered a vessel wall expansion > 20% following PCI.

Etiology
Coronary artery aneurysms or pseudoaneurysms, are rare findings after balloon angioplasty, atheroablation, and coronary stenting. Coronary artery aneurysms likely arise from tears or dissection and incomplete healing that compromises the vessel wall integrity and result in vessel wall expansion.

Coronary artery aneurysms are also rarely (<1%) seen after drug eluting stent placement, although the pathologic etiology of aneurysms in this setting may relate to expansion of all three layers of the arterial wall due to inflammation and effects from the cytostatic or cytotoxic drugs and malapposition of the stent struts (1, 2). Under rare circumstances, coronary artery aneurysms can become infected requiring surgical intervention (3, 4).


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