title: Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates.
abstract: 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.
authors.affiliation: 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
authors.forename: On
authors.initials: O
authors.lastname: Topaz
authors.forename: Molly S
authors.initials: MS
authors.lastname: Rutherford
authors.forename: Shannon
authors.initials: S
authors.lastname: Mackey-Bojack
authors.forename: Andreas W
authors.initials: AW
authors.lastname: Prinz
authors.forename: Sadasiv
authors.initials: S
authors.lastname: Katta
authors.forename: David
authors.initials: D
authors.lastname: Salter
authors.forename: Jack L
authors.initials: JL
authors.lastname: Titus
mesh_terms: 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