title: Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation.
abstract: OBJECTIVE
  There is a growing concern about the occurrence of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation and their long-term course. We assessed the occurrence and the factors affecting the long-term outcome of DES-associated CAA.
  
  
  RESULTS
  We analyzed 3,612 consecutive patients (4,419 lesions) who underwent follow-up angiography after DES implantation. All 34 CAAs (0.76% per lesion) in 29 patients (0.8% per patient) were detected at follow-up, and the mean elapsed time from DES implantation to CAA diagnosis was 414 ± 213 days. Angiographically, CAAs developed almost exclusively in complex (type B2/C) de novo lesions (30 [88.2%] of 34 lesions), and lesion length was significantly greater in patients with CAA than without CAA (26.9 ± 9.03 vs 23.1 ± 7.14 mm; P = .004). Myocardial infarction with stent thrombosis occurred in 5 patients with CAA (17.2%), 4 of whom were on aspirin only without clopidogrel.
  
  
  CONCLUSIONS
  Although CAAs rarely develop after DES implantation and show mostly favorable clinical courses, long-term maintenance of clopidogrel therapy might be required to minimize occurrence of adverse clinical events resulting from stent thrombosis.
authors.affiliation: Cardiovascular Center, Anam Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Ahn
authors.forename: Bum-Kee
authors.initials: BK
authors.lastname: Hong
authors.forename: Jong-Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Pil-Ki
authors.initials: PK
authors.lastname: Min
authors.forename: Young W
authors.initials: YW
authors.lastname: Yoon
authors.forename: Byoung K
authors.initials: BK
authors.lastname: Lee
authors.forename: Hyuck M
authors.initials: HM
authors.lastname: Kwon
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Won-Heum
authors.initials: WH
authors.lastname: Shim
authors.forename: Seung-Yun
authors.initials: SY
authors.lastname: Cho
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Seongjin
authors.initials: S
authors.lastname: Oh
authors.forename: Dong W
authors.initials: DW
authors.lastname: Jeon
authors.forename: Joo Y
authors.initials: JY
authors.lastname: Yang
authors.forename: Jae-Hun
authors.initials: JH
authors.lastname: Jung
mesh_terms: D003323:Coronary Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors