An intravascular ultrasound classification of angiographic coronary artery aneurysms

The purpose of this study was to use intravascular ultrasound (IVUS) to clarify the morphology of coronary aneurysms diagnosed by angiography. Seventy-seven consecutive patients with an aneurysmal dilatation in a native coronary artery diagnosed by angiography (defined as a lesion lumen diameter 25%...

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Bibliographic Details
Published in:The American journal of cardiology 2001-08, Vol.88 (4), p.365-370
Main Authors: Maehara, Akiko, Mintz, Gary S, Ahmed, Javed M, Fuchs, Shmuel, Castagna, Marco T, Pichard, August D, Satler, Lowell F, Waksman, Ron, Suddath, William O, Kent, Kenneth M, Weissman, Neil J
Format: Article
Language:English
Subjects:
Aged
Aneurysm, False - diagnostic imaging
Aneurysms
Biological and medical sciences
Cardiology. Vascular system
Constriction, Pathologic
Coronary Aneurysm - diagnostic imaging
Coronary Aneurysm - pathology
Coronary Angiography
Coronary Artery Disease - pathology
Coronary heart disease
Coronary Vessels - pathology
Dilatation, Pathologic
Female
Heart
Humans
Male
Medical diagnosis
Medical sciences
Middle Aged
Ultrasonic technology
Ultrasonography, Interventional
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Summary:The purpose of this study was to use intravascular ultrasound (IVUS) to clarify the morphology of coronary aneurysms diagnosed by angiography. Seventy-seven consecutive patients with an aneurysmal dilatation in a native coronary artery diagnosed by angiography (defined as a lesion lumen diameter 25% larger than reference) were evaluated by IVUS. IVUS true aneurysms were defined as having an intact vessel wall and a maximum lumen area 50% larger than proximal reference. IVUS pseudoaneurysms had a loss of vessel wall integrity and damage to adventitia or perivascular tissue. Complex plaques were lesions with ruptured plaque or spontaneous or unhealed dissection. Aneurysmal dilatation and reference segments were assessed using standard IVUS quantitative techniques. Twenty-one lesions (27%) were classified as true aneurysms, 3 (4%) were classified as pseudoaneurysms, 12 (16%) were complex plaques, and the other 41 (53%) were normal arterial segments adjacent to ≥1 stenosis. The maximum lumen area within the aneurysmal segment was largest for pseudoaneurysm (35.1 ± 10.4 mm2), 22.1 ± 9.9 mm2 for true aneurysm, and similar for complex plaques (11.2 ± 3.5 mm2) and normal segments with adjacent stenoses (13.8 ± 6.4 mm2): analysis of variance, p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(01)01680-0