冠状动脉瘤 coronary artery aneurysm - PubMed 文献
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关于 冠状动脉瘤
冠状动脉瘤（coronary artery aneurysm, CAA）是指冠状动脉管腔局限性扩张，其直径超过邻近正常血管段直径的1.5倍，可单发或多发，属于心血管疾病中的冠状动脉异常范畴。根据形态可分为囊状动脉瘤和梭形动脉瘤；根据病因可分为动脉粥样硬化性、先天性、感染性（如川崎病、梅毒）、创伤性、结缔组织病相关及介入术后获得性等。中文亦称“冠状动脉扩张症”“冠状动脉瘤样扩张”，英文近义词包括coronary artery ectasia、coronary aneurysm。该病在临床上相对少见，但可导致血栓形成、破裂、压迫周围结构及心肌缺血等严重并发症。
冠状动脉瘤的研究热点集中于病因与发病机制、影像学诊断与随访、以及治疗策略的优化。经典议题包括川崎病后冠状动脉瘤的自然病程与远期风险、动脉粥样硬化与冠状动脉扩张症的关系、以及经皮冠状动脉介入治疗（PCI）后获得性动脉瘤的形成机制。影像学方面，冠状动脉CTA和血管内超声（IVUS）在评估瘤体大小、附壁血栓及管壁结构中的应用受到持续关注。治疗上，抗血小板与抗凝治疗的平衡、覆膜支架植入及外科手术的适应证选择是争论焦点。代表性期刊包括《Circulation》《Journal of the American College of Cardiology》《Catheterization and Cardiovascular Interventions》等，学者如Kawasaki、Burns等在该领域有重要贡献。
PubMed增强版为关注冠状动脉瘤的研究者与临床医生提供多项实用功能：支持中英文摘要对照翻译，帮助快速理解非母语文献；显示期刊影响因子与分区，辅助评估文献学术影响力；提供PDF全文下载链接，便于获取原始研究；内置AI阅读工具可自动提取核心结论、研究设计与关键数据，提升文献筛选与阅读效率。这些功能有助于用户系统追踪冠状动脉瘤的病因、诊断与治疗进展。
冠状动脉瘤 的 PubMed 搜索结果
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[Kawasaki disease in Sicily: description of the first case with giant coronary aneurysm]. [西西里岛川崎病：首例巨大冠状动脉瘤病例描述]
A case of Kawasaki disease with early development of giant coronary artery aneurysm is reported. The delay in the diagnosis and consequently in the use of correct therapy has conditioned the outcome of the illness. We don't know the predictive factors of cardiac complications, but steroid treatment in our patient probably had an important role in the cardiac damage. The use of echocardiography in the evaluation of coronary aneurysm has confirmed the sensitivity, specificity and predictive value of this technique in detecting cardiac lesions.
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Non-fistulous idiopathic coronary artery aneurysm. Report of three cases and literature review. 非瘘性特发性冠状动脉瘤。三例报告及文献综述
Non-fistulous idiopathic aneurysm of coronary arteries is a rare anomaly, often localized on the left coronary trunk and diagnosed in young patients following myocardial ischemia. Diagnosis before death is only possible since advent of selective coronary angiography. Idiopathic etiology can be inferred when the aneurysm is found in the absence of atherosclerosis and calcification of other arteries and if there is an absence of risk factors for atherosclerosis. Inflammatory etiology is excluded by a negative clinical history and lack of histologic inflammatory features. However, cumulating observations suggest that angeitis or other acquired process cannot definitely be disapproved. Advances in coronary artery surgery have permitted resection of aneurysms and grafting of involved coronary artery since the early seventies. Three cases of non-fistulous idiopathic aneurysms of coronary arteries are presented. The literature has been reviewed and the clinical, anatomic, angiographic findings and management are discussed.
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Giant coronary artery aneurysm mimicking a compressive cardiac tumor Imaging features and operative strategy. 模拟压迫性心脏肿瘤的巨大冠状动脉瘤：影像学特征与手术策略
Giant atheromatous coronary aneurysms mimicking a cardiac tumor remain exceptional. We report the case of a patient who experienced a severe inferior myocardial infarction related to a giant thrombosed coronary aneurysm masquerading a cardiac tumor and compressing right cardiac cavities with mechanical detrimental consequences on tricuspid, mitral and aortic valvular competence. The contribution of imaging was essential to assess diagnosis, understand the physiopathogeny of myocardial and valvular consequences and plan the optimal surgical strategy.
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Anterior wall myocardial infarction in a 16-year-old man caused by coronary artery aneurysm during the outbreak of COVID-19. COVID-19疫情期间由冠状动脉瘤引起的16岁男性前壁心肌梗死
Coronary artery aneurysm (CAA) is a potential cause of infarction. During the outbreak of coronavirus disease 2019 (COVID-19), home isolation and activity reduction can lead to hypercoagulability. Here, we report a case of sudden acute myocardial infarction caused by large CAA during the home isolation. During the outbreak of coronavirus disease 2019 (COVID-19),a 16-year-old man with no cardiac history was admitted to CCU of Tang du hospital because of severe chest pain for 8 h. The patient reached the hospital its own, his electrocardiogram showed typical features of anterior wall infarction, echocardiography was performed and revealed local anterior wall dysfunction, but left ventricle ejection fraction was normal, initial high-sensitivity troponin level was 7.51 ng/mL (<1.0 ng/mL). The patient received loading dose of aspirin and clopidogrel bisulfate and a total occlusion of the LAD was observed in the emergency coronary angiography (CAG). After repeated aspiration of the thrombus, TIMI blood flow reached level 3. Coronary artery aneurysm was visualized in the last angiography. No stent was implanted. Intravascular ultrasound (IVUS) was performed and the diagnosis of coronary artery aneurysm was further confirmed. The patient was discharged with a better health condition. Coronary artery aneurysm is a potential reason of infarction, CAG and IVUS are valuable tools in diagnosis in such cases, during the outbreak of coronavirus disease 2019 (COVID-19), home isolation and activity reduction can lead to hypercoagulability, and activities at home should be increased in the high-risk patients.
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Left-circumflex coronary artery to right atrium fistula with saccular aneurysm and its endovascular treatment. 左回旋支冠状动脉至右心房瘘伴囊状动脉瘤及其血管内治疗
The combination of coronary artery aneurysm and coronary artery fistula is infrequent. A saccular aneurysm of a branch of the left-circumflex coronary artery associated with multiple fistulae to the right atrium was observed on a coronary angiogram performed in a 47-year-old female. Multidetector computed tomography coronary angiography detailed the anatomy of the abnormal coronary artery. An embolization with a microcoil was performed and the aneurysm sac was excluded.
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[Coronary artery aneurysm associated with fistula: two anatomically similar cases with different clinical presentation]. [伴瘘的冠状动脉瘤：两例解剖相似但临床表现不同的病例]
Coronary artery fistulas are rare anomalies and their association with a coronary aneurysm even more infrequent. We report two cases which are illustrative because of their different clinical presentations. In the first case the diagnosis was made after discovering fortuitously a heart murmur. In contrast in the second case the coronary artery fistula was demonstrated during a check-up for thoracic pain. In both cases the right coronary artery gave a fistulous communication to the right atrium.
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The long-term vascular and myocardial outcomes in selected Kawasaki disease patients with regression of giant coronary artery aneurysms. 巨大冠状动脉瘤消退的特定川崎病患者长期血管和心肌结局
Giant coronary artery aneurysms and myocardial fibrosis after Kawasaki disease may lead to devastating cardiovascular outcomes. We characterised the vascular and myocardial outcomes in five selected Kawasaki disease patients with a history of giant coronary artery aneurysms that completely regressed. Five patients were selected who had giant coronary artery aneurysm in early childhood that regressed when studied 12-33 years after Kawasaki disease onset. Coronary arteries were imaged by coronary CT angiography, and coronary artery calcium volume scores were determined. We used endocardial strain measurements from CT imaging to assess myocardial regional wall function. Calprotectin and galectin-3 (gal-3) as biomarkers of inflammation and myocardial fibrosis were measured by enzyme-linked immunosorbent assay. The five selected patients with regressed giant coronary artery aneurysms had calcium scores of zero, normal levels of calprotectin and gal-3, and normal appearance of the coronary arteries by coronary computed tomography angiography. CT strain demonstrated normal peak systolic and diastolic strain patterns in four of five patients. In one patient with a myocardial infarction at the time of Kawasaki disease diagnosis at the age of 10 months, CT strain showed altered global longitudinal strain, reduced segmental peak strain, and reduced diastolic relaxation patterns in multiple left ventricle segments. These patients illustrate that regression of giant aneurysms after Kawasaki disease is possible with no detectable calcium, normal biomarkers of inflammation and fibrosis, and normal myocardial function. Individuals with regressed giant coronary artery aneurysm still require longitudinal surveillance to assess the durability of this favourable outcome.
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Preoperative and postoperative evaluation of multiple giant coronary aneurysms by the use of coronary CT angiography with 64-MDCT: a case of multiple giant coronary aneurysms treated with aneurysmectomy and coronary artery bypass surgery. 使用64排MDCT冠状动脉CT血管造影对多发性巨大冠状动脉瘤进行术前和术后评估：一例接受动脉瘤切除术和冠状动脉旁路手术治��的多发性巨大冠状动脉瘤病例
A coronary artery aneurysm is an uncommon disorder and is seen as a characteristic dilatation of a localized portion of the coronary artery. Clinical manifestation of a coronary artery aneurysm varies from an asymptomatic presentation to sudden death of a patient. Although coronary aneurysms are typically diagnosed by the use of coronary angiography, a new generation of coronary 64-slice multidetector computed tomography (64-MDCT) scanners have successfully been used for evaluating this abnormality in a noninvasive manner. In the present case, we performed coronary 64-MDCT scanning preoperatively and postoperatively on a patient with multiple giant coronary aneurysms. The use of coronary 64-MDCT may provide an evaluation technique not only for diagnosis but also for follow-up after surgery for this condition.
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Bilateral common iliac artery aneurysms secondary to fibromuscular dysplasia accompanied with a coronary aneurysm. A case report. 继发于纤维肌性发育不良的双侧髂总动脉瘤伴冠状动脉瘤。一例报告
Fibromuscular dysplasia (FMD) is found in various arteries but the common iliac arteries and the coronary arteries are seldom involved. A 49-year-old woman was referred to our hospital with a pulsatile mass in her right lower quadrant. She had subdural hemorrhage in a postpartum state at the age of 27. After admission angiography diagnosed the bilateral iliac artery aneurysms and coronary angiography revealed a coronary artery aneurysm, the size of which was 12 mm x 19 mm in the region of the left main trunk. The bilateral iliac artery aneurysms were resected and Y-shaped vascular prosthesis was replaced. Microscopic sections of the aneurysm showed remarkable decrease of elastic fibers and thinning of the media, but no increase occurred in the smooth muscle. Histopathological diagnosis was FMD (periarterial fibroplasia). To our knowledge, no patient with a iliac arterial aneurysm caused by FMD has been reported and only a few cases with coronary arterial FMD have been described. This is the first report of iliac arterial aneurysm due to FMD. Since this case has multiple aneurysms, a long-term follow-up is definitely required, especially focusing on the coronary aneurysm.
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Congenital giant aneurysm of the left coronary artery. 先天性左冠状动脉巨大动脉瘤
We report an unusual case of congenital giant coronary aneurysm. A 23 year-old male with a history of acute myocardial infarction presented an abnormal shadow in the left cardiac border on routine X-ray. Electrocardiogram and physical examination were normal without any clinical signs of inflammation, but computed tomography (CT) scan and cardiac magnetic resonance imaging (MRI) revealed a giant (>50mm) coronary aneurysm. Coronary artery bypass grafting (CABG) with coronary artery aneurysm (CAA) resection resolved the CAA. Coronary artery aneurysms are entities of localised dilation and can be common events in chronic infectious disease as a result of the systemic inflammatory state; however, giant coronary aneurysms (measuring more than 50mm) are rare. This is especially true where the pathological aetiology was not clearly defined or was believed to be of congenital origin. To date only a few published case reports exist for this type of pathological entity.