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Barioli et al. Vessel Plus 2024;8:13 https://dx.doi.org/10.20517/2574-1209.2023.68 Page 5 of 14

Table 1. Therapeutic strategies for CAAs and CAEs
Treatment modality Rationale Advantages Disadvantages
Medical ACEi/ARBs/Statins Control CVRF/Slow CAA dilation Easy access Neither removal nor exclusion of CAA
therapy rate? Wide availability Risk of bleeding with long-term
antithrombotic therapies
DAPT vs. SAPT vs. Reduce thrombotic
OAC complications
IVIG therapy Kawasaki disease-related CAA
PCI Covered Stent Exclusion of smaller CAA Lower risk or procedural No removal of CAA/risk of CAA
Prevention of CAA rupture complications/quick coronary rupture/endoleaks/stent
Double stent method
Coronary flow restoration in case flow restoration malapposition/vessel occlusion
Self-expanding stents of ongoing ischemia
Coil embolization ±
stent-assisted
Cardiac Resection/ligation/ Treatment of larger/giant CAA Complete removal of CAA Higher risk of procedural complications
surgery marsupialization at high risk of rupture or Treatment of CAA/CAD
involving LMCA/proximal vessel unsuitable for PCI
CABG Treatment of concomitant
obstructive CAD
ACEi: Angiotensin converting enzyme inhibitors; ARBs: angiotensin II receptor blockers; DAPT: dual antiplatelet therapy; SAPT: single antiplatelet
therapy; OAC: oral anticoagulant; CAA: coronary artery aneurysm; CAE: coronary artery ectasia; CVRF: cardiovascular risk factors; PCI:
percutaneous coronary intervention; CABG: coronary artery bypass graft; LMCA: left main coronary artery; CAD: coronary artery disease.

Figure 2. Angiographic (A) and CT-scan (B) appearance of a LAD saccular aneurysm (double arrows) in a patient with prior CABG. (C
and D) show patency of LIMA to LAD and SVG to OM grafts, respectively. CT: Computed tomography; LAD: left anterior descending
artery; CABG: coronary artery bypass grafting; LIMA: left internal mammary artery; SVG: saphenous vein graft; OM: obtuse marginal.