Coronary Artery Aneurysm and Ectasia Management
Summary
Coronary artery aneurysm (CAA) and coronary artery ectasia (CAE) are distinct but overlapping entities characterised by pathological dilation of the coronary vasculature. Aneurysms are focal dilatations exceeding 1.5 times the diameter of adjacent normal segments, while ectasia denotes diffuse involvement spanning more than half the length of a vessel. Both conditions arise most commonly in adults through atherosclerotic degradation of the vessel wall and in children through inflammatory vasculitides such as Kawasaki disease. The clinical spectrum ranges from incidental angiographic findings to life-threatening thrombosis, distal embolisation, ischaemia and, rarely, rupture. Diagnostic evaluation begins with invasive coronary angiography and is increasingly complemented by non-invasive imaging modalities such as coronary CT and intravascular ultrasound to assess lesion morphology, wall integrity and dynamic flow patterns. Management must be individualised, balancing the risk of intervention against that of progressive thrombotic or ischaemic complications. Medical therapy includes antiplatelet and anticoagulant regimens, whereas percutaneous approaches may employ covered stents or coil embolisation. Surgical options such as aneurysm resection with bypass grafting are reserved for large or complex lesions. Despite advances, consensus on optimal therapeutic algorithms remains elusive, and multidisciplinary assessment is essential to optimise outcomes globally.
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Coronary Artery Aneurysm and Ectasia Management publication trend
The graph below shows the total number of articles in coronary artery aneurysm and ectasia management across all publications each year (not limited to Nature Index journals).
Technical terms
Coronary artery aneurysm (CAA): A focal dilation of a coronary segment exceeding 1.5 times the diameter of adjacent normal vessel.
Coronary artery ectasia (CAE): Diffuse dilatation of a coronary artery affecting more than 50% of its length and exceeding 1.5 times the normal diameter.
Damage-associated molecular patterns (DAMPs): Endogenous molecules released by stressed or damaged cells that activate innate immune responses.
Matrix metalloproteinases (MMPs): A family of proteolytic enzymes that degrade extracellular matrix components and contribute to vessel wall remodelling.
Covered stent: An intravascular device with a biocompatible sheath designed to exclude aneurysmal segments and restore luminal integrity.
References
- Coronary Artery Aneurysm or Ectasia as a Form of Coronary Artery Remodeling: Etiology, Pathogenesis, Diagnostics, Complications, and Treatment. Biomedicines (2024).
- Differential Expression of Circulating Damage-Associated Molecular Patterns in Patients with Coronary Artery Ectasia. Biomolecules (2023).
- New Insights into the Pathophysiology of Coronary Artery Aneurysms. Diagnostics (2024).
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