Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques
Background: Coronary aneurysms are an infrequent finding in diagnostic angiography, with a reported incidence of 0.35–0.7% in the largest contemporary registries. At least half of them have an atherosclerotic etiology and as such they are often diagnosed in the setting of acute coronary syndrome. Th...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Vascular Diseases |
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| Online Access: | https://www.mdpi.com/2813-2475/2/4/31 |
| _version_ | 1797380303295086592 |
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| author | Jacek Klaudel Piotr Radowski Wojciech Trenkner Michał Glaza Krzysztof Pawłowski Dariusz Surman Włodzimierz Krasowski Marek Szołkiewicz |
| author_facet | Jacek Klaudel Piotr Radowski Wojciech Trenkner Michał Glaza Krzysztof Pawłowski Dariusz Surman Włodzimierz Krasowski Marek Szołkiewicz |
| author_sort | Jacek Klaudel |
| collection | DOAJ |
| description | Background: Coronary aneurysms are an infrequent finding in diagnostic angiography, with a reported incidence of 0.35–0.7% in the largest contemporary registries. At least half of them have an atherosclerotic etiology and as such they are often diagnosed in the setting of acute coronary syndrome. The wiring of a thrombosed aneurysm is a difficult task and after successful recanalization, the operator has to decide on the optimal method of aneurysm exclusion. Covered stents are commonly deployed, but their use involves the risk of delivery failure as well as device dislodgement and loss due to their stiffness and size. Moreover, proper stent sizing and apposition is difficult in the case of thrombosed aneurysms. Case presentation: We present a case of coronary aneurysm recanalization and exclusion with a covered stent, with a postdilation-induced stent foreshortening. Due to the subsequent stent migration into the aneurysm sac, its repositioning was attempted. The pitfalls of coronary aneurysm stenting and neurointerventional techniques of prolapsed device realignment are discussed. Conclusions: An adequate landing zone is of the utmost importance in aneurysm exclusion with covered stents. In the case of a short stent anchoring in the normal vessel, another covered or conventional stent should be deployed to mitigate the risk of the device migration. |
| first_indexed | 2024-03-08T20:36:25Z |
| format | Article |
| id | doaj.art-023d4a7018e2452daec36eae7d89aaf9 |
| institution | Directory Open Access Journal |
| issn | 2813-2475 |
| language | English |
| last_indexed | 2024-03-08T20:36:25Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Vascular Diseases |
| spelling | doaj.art-023d4a7018e2452daec36eae7d89aaf92023-12-22T14:20:15ZengMDPI AGJournal of Vascular Diseases2813-24752023-11-012440241210.3390/jvd2040031Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment TechniquesJacek Klaudel0Piotr Radowski1Wojciech Trenkner2Michał Glaza3Krzysztof Pawłowski4Dariusz Surman5Włodzimierz Krasowski6Marek Szołkiewicz7Department of Invasive Cardiology and Interventional Radiology, St. Adalbert’s Hospital, Copernicus PL, 80-462 Gdansk, PolandDepartment of Invasive Cardiology and Interventional Radiology, St. Adalbert’s Hospital, Copernicus PL, 80-462 Gdansk, PolandDepartment of Invasive Cardiology and Interventional Radiology, St. Adalbert’s Hospital, Copernicus PL, 80-462 Gdansk, PolandDepartment of Cardiology, St. Vincent de Paul Hospital Pomeranian Hospitals, 81-348 Gdynia, PolandDepartment of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, PolandDepartment of Invasive Cardiology and Interventional Radiology, St. Adalbert’s Hospital, Copernicus PL, 80-462 Gdansk, PolandDepartment of Invasive Cardiology and Interventional Radiology, St. Adalbert’s Hospital, Copernicus PL, 80-462 Gdansk, PolandDepartment of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, PolandBackground: Coronary aneurysms are an infrequent finding in diagnostic angiography, with a reported incidence of 0.35–0.7% in the largest contemporary registries. At least half of them have an atherosclerotic etiology and as such they are often diagnosed in the setting of acute coronary syndrome. The wiring of a thrombosed aneurysm is a difficult task and after successful recanalization, the operator has to decide on the optimal method of aneurysm exclusion. Covered stents are commonly deployed, but their use involves the risk of delivery failure as well as device dislodgement and loss due to their stiffness and size. Moreover, proper stent sizing and apposition is difficult in the case of thrombosed aneurysms. Case presentation: We present a case of coronary aneurysm recanalization and exclusion with a covered stent, with a postdilation-induced stent foreshortening. Due to the subsequent stent migration into the aneurysm sac, its repositioning was attempted. The pitfalls of coronary aneurysm stenting and neurointerventional techniques of prolapsed device realignment are discussed. Conclusions: An adequate landing zone is of the utmost importance in aneurysm exclusion with covered stents. In the case of a short stent anchoring in the normal vessel, another covered or conventional stent should be deployed to mitigate the risk of the device migration.https://www.mdpi.com/2813-2475/2/4/31coronary aneurysmstent herniationstent migrationstent prolapsestent realignmentcovered stent |
| spellingShingle | Jacek Klaudel Piotr Radowski Wojciech Trenkner Michał Glaza Krzysztof Pawłowski Dariusz Surman Włodzimierz Krasowski Marek Szołkiewicz Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques Journal of Vascular Diseases coronary aneurysm stent herniation stent migration stent prolapse stent realignment covered stent |
| title | Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques |
| title_full | Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques |
| title_fullStr | Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques |
| title_full_unstemmed | Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques |
| title_short | Covered Stent Herniation into Coronary Aneurysm Sac—A Case-Inspired Review of Neurointerventional Realignment Techniques |
| title_sort | covered stent herniation into coronary aneurysm sac a case inspired review of neurointerventional realignment techniques |
| topic | coronary aneurysm stent herniation stent migration stent prolapse stent realignment covered stent |
| url | https://www.mdpi.com/2813-2475/2/4/31 |
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