Short- or long-term outcomes of coronary artery aneurysms occurring after directional coronary atherectomy
Oikawa, Y.; Yajima, J.; Angiolillo, D.J.; Akabane, M.; Funada, R.; Matsuno, S.; Inaba, T.; Nakagawa, Y.; Nakamura, M.; Sawada, H.; Aizawa, T.
Journal of Invasive Cardiology 20(4): 159-160
2008
ISSN/ISBN: 1557-2501 PMID: 18398229 Document Number: 616455
Coronary artery aneurysm (CAA) often occurs after percutaneous coronary intervention, and it could be recognized more often in coronary intervention with directional coronary atherectomy (DCA). However, it has been uncertain and the natural history of CAA after DCA remains obscure. Thus, we examined the clinical course after DCA. This study included 792 lesions in which a follow-up angiogram was completed at mid- or long-term (3 months [mos.] or more than 1 year after DCA). The mean average of the angiographic follow-up period was 24.8 mos. (range 3-128 mos.), and clinical follow-up period was 45.6 mos. (range 3-144 mos.). CAA was defined as 1.5 > DCA site diameter/reference diameter by quantitative coronary angiography (QCA). CAAs were detected in 21 lesions (2.7%). There was no significant difference in the target lesion revascularization rate between CAA and non-CAA lesion (19.0% vs. 24.6%). More than twice as many follow-up coronary angiograms were performed in 15 lesions among 21 CAA lesions. The mean duration of the follow-up angiograms was 19.6 mos. There was no significant difference in lumen diameter between the value of QCA at first and final follow-up coronary angiography (3.9 +/- 0.9 vs. 4.0 +/- 0.8 mm). Acute coronary events or coronary perforations did not occur at all. This study showed the frequency of DCA-related CAA and revealed acceptable short- or long-term prognosis. DCA-related CAA had not been progressing during the follow-up period. We concluded that almost all CAAs should be managed conservatively.