Exclusion of Giant Coronary Artery Aneurysm with Covered Stent Combined with Coil Embolization of Vessel Outflow

Background: Coronary artery aneurysms (CAA) are rare abnormal dilatation of the coronary arteries. They are termed giant if their diameter exceeds the reference vessel diameter by more than 4 times or if they are more than 8 mm in diameter. If not treated, they have a tendency to rupture, thrombose or embolize. There is however no definite therapy for CAA. Various therapies suggested in the management of aneurysms include surgical resection, covered stent implantation or coil embolization. Methods: We describe a case of coiling of a potential collateral vessel feeding the giant coronary aneurysm retrogradely and covered stenting of main branch to exclude the aneurysm. Results: Transcatheter embolization was successfully done. No late complications were seen during 1 year CT angiography. Conclusion: Dual stent and coil embolization is safe and effective for vessel outflow during the treatment of giant coronary artery aneurysm. Further long term outcomes will have to be determined through serial CT angiographies