Treatment of coronary artery aneurysm with a drug-eluting, vein-covered stent

A coronary artery aneurysm (CAA) is defined as a localized dilatation of the coronary artery exceeding 1.5 times the diameter of the adjacent section of the coronary artery [1]. The incidence of CAA among patients who have undergone coronary angiography (CAG) varies from 0.3 to 4.9 % [1]. CAA most commonly involves the right coronary artery, followed by the left anterior descending artery (LAD) and the left circumflex coronary arteries [2]. More than 50 % of CAAs are atherosclerotic [3]. The natural history and prognosis of CAA are unknown, but reported complications include thrombosis, rupture, embolism, vasospasm, and myocardial infarction [3, 4]. Treatment strategies have focused on anticoagulant or antiplatelet therapy, surgical resection, and percutaneous interventions. Percutaneous interventions offer a less invasive alternative to surgical treatments, but short- and long- term outcomes remain unknown [5]. We report a case of an elderly patient with a stenotic lesion and CAA resulting from atherosclerotic disease. The CAA was treated successfully with a combination of an autologous vein graft and a drug- eluting stent (DES). After the procedure, follow- up CAG revealed no leakage or restenosis.