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Hassan A, Uretsky BF, Vargas Estrada AM, Hassan R, Al-Hawwas M, Agarwal SK. Systematic review of the evaluation and management of coronary pseudoaneurysm after stent implantation. Catheter Cardiovasc Interv 2021; 98:107-116. [PMID: 33016651 DOI: 10.1002/ccd.29312] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/02/2020] [Accepted: 09/23/2020] [Indexed: 11/11/2022]
Abstract
Pseudoaneurysm (PSA) formation is a rare but well-known complication of coronary stenting. It develops after a procedural perforation disrupts the integrity of the vessel wall but is contained by a single wall layer, usually pericardium, extravascular thrombosis and later fibrosis. Medical literature of PSA consists primarily of case reports. A systematic review of pseudoaneurysm after coronary stenting was performed to summarize its presentation, diagnostic imaging modalities, natural history, and management approaches. Clinical presentations range from asymptomatic to hemodynamic collapse, size from small to "giant," and treatment approaches from surgical or percutaneous exclusion to "watchful waiting" and imaging surveillance. Based on current information, a management algorithm is provided recommending urgent to emergent exclusion for symptomatic PSA, elective exclusion for large and giant PSA, and "watchful waiting" and periodic imaging surveillance for small to moderate sized PSA.
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Affiliation(s)
- Atif Hassan
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Barry F Uretsky
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Internal Medicine, Central Arkansas Veterans Health System, Little Rock, Arkansas, USA
| | | | - Romesa Hassan
- Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA
| | - Malek Al-Hawwas
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Internal Medicine, Central Arkansas Veterans Health System, Little Rock, Arkansas, USA
| | - Shiv Kumar Agarwal
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.,Department of Internal Medicine, Central Arkansas Veterans Health System, Little Rock, Arkansas, USA
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Çelik O, Bekar L, Yetim M, Doğan T, Alp Ç, Kalçık M, Karavelioğlu Y. A rare complication of percutaneous coronary intervention: Coronary pseudoaneurysm formation. Interv Med Appl Sci 2018; 9:208-211. [PMID: 29951287 PMCID: PMC6016209 DOI: 10.1556/1646.9.2017.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Coronary pseudoaneurysms (CPAs) are rare complications developed after percutaneous coronary interventions. They may cause stent thrombosis, distal embolization, and coronary rupture leading to cardiac tamponade. Therefore, high-risk CPA should be promptly treated after diagnosis. They can be managed with percutaneous or surgical intervention. Herein, we aimed to present a patient who developed CPA 3 weeks after percutaneous coronary intervention and successfully treated with percutaneous intervention using a covered stent.
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Affiliation(s)
- Oğuzhan Çelik
- Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey
| | - Lütfü Bekar
- Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Mucahit Yetim
- Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey
| | - Tolga Doğan
- Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey
| | - Çağlar Alp
- Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey
| | - Macit Kalçık
- Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Yusuf Karavelioğlu
- Department of Cardiology, Hitit University Faculty of Medicine, Çorum, Turkey
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