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Barioli et al. Vessel Plus 2024;8:13 Vessel Plus
DOI: 10.20517/2574-1209.2023.68

Review Open Access

Diagnostic workup and treatment options for

aneurysmal coronary artery disease

Alberto Barioli , Emanuele Visco, Nicola Pellizzari, Filippo Marzot, Davide Lanzellotti, Luca Favero,
Carlo Cernetti

Cardio-Neuro-Vascular Department, Cà Foncello and San Giacomo Hospital, Treviso 31100, Italy.
Correspondence to: Dr. Alberto Barioli, Cardio-Neuro-Vascular Department, Cà Foncello and San Giacomo Hospital, Azienda
No. 2 Marca Trevigiana, Treviso 31100, Italy. E-mail: albertobarioli@gmail.com

How to cite this article: Barioli A, Visco E, Pellizzari N, Marzot F, Lanzellotti D, Favero L, Cernetti C. Diagnostic workup and
treatment options for aneurysmal coronary artery disease. Vessel Plus 2024;8:13. https://dx.doi.org/10.20517/2574-1209.2023.
68

Received: 15 Jun 2023 First Decision: 8 Dec 2023 Revised: 29 Jan 2024 Accepted: 1 Mar 2024 Published: 13 Mar 2024

Academic Editors: Manel Sabaté, Christopher Lau Copy Editor: Fangyuan Liu Production Editor: Fangyuan Liu

Abstract
Coronary artery aneurysms and coronary ectasia are defined as focal or diffuse dilation of the coronary arteries,
respectively. Although frequently silent and detected as incidental findings at coronary angiography or computed
tomography, coronary aneurysms have been associated with different clinical conditions, including silent ischemia
and acute coronary syndromes, and with poor clinical outcomes. The optimal management still remains unsettled,
as randomized data are lacking and treatment with either surgical or percutaneous procedures faces significant
challenges. This review aims to provide an update on the classification, etiopathogenesis, diagnostic workup, and
treatment of aneurysmal coronary disease.

Keywords: Coronary artery aneurysm, coronary artery ectasia, coronary artery disease, percutaneous coronary
intervention

INTRODUCTION
Coronary artery aneurysm (CAA) and ectasia (CAE), usually collectively referred to as aneurysmal coronary
artery disease, are defined as focal or diffuse coronary dilations that exceed 1.5 times the diameter of the
adjacent normal segment. Although frequently used interchangeably, the two terms reflect a different extent
of the disease: the term aneurysm should be used to describe those dilations involving less than 50% of the

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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