Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates.
BACKGROUND
Giant aneurysms that develop in native coronary arteries or saphenous vein grafts are morphologically defined as abnormally expanded outpouching vascular structures >4 cm in diameter. The location, morphology, and content of giant aneurysms account for adverse cardiovascular effects.


METHODS
Two cases of giant aneurysms were studied comprehensively by noninvasive and invasive cardiac methods and subsequent histopathology. The first patient had a giant aneurysm that developed over a course of several years in a saphenous vein graft whereas the second patient had a giant aneurysm occurring within a native coronary artery. Accompanying clinical and angiographic findings are described.


RESULTS
Atherosclerosis and thrombosis were among the prominent histopathological findings.


CONCLUSIONS
Atherosclerosis and associated thrombosis within giant aneurysms result in obstruction of flow, distal embolization, and development of acute coronary syndromes including recurrent ischemic chest pain, unstable angina, and acute myocardial infarction. The options for clinical management of giant coronary or vein graft aneurysms include surgical excision, percutaneous coil occlusion and stent deployment, or medical approach.
Topaz
On
O
Division of Cardiology and Pathology, McGuire Veterans Affairs Medical Center, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23249, USA. on.topaz@med.va.gov
Rutherford
Molly S
MS
Mackey-Bojack
Shannon
S
Prinz
Andreas W
AW
Katta
Sadasiv
S
Salter
David
D
Titus
Jack L
JL
D000368:Aged; D050197:Atherosclerosis / Q000209:etiology / Q000473:pathology; D003323:Coronary Aneurysm / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology*; D006083:Graft Occlusion, Vascular / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000473:pathology* / Q000637:transplantation; D013927:Thrombosis / Q000209:etiology / Q000473:pathology