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(A) Coronary angiography revealed a significant stenosis of the LAD-LCx bifurcation. (B) Final view after culotte stenting.
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No PSA was detected before or after percutaneous coronary intervention (Figure 1; Supplementary material online, Videos S1 and S2).
(A) A coronary angiography illustrates a small aneurysm after culotte stenting in May 2021. (B) Upon admission in June 2021, computed tomography shows the aneurysm of the LCx.
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At that time, there was no need for a therapeutic intervention (Figure 2A; Supplementary material online, Video S1). The overview computed tomography (CT) at admission showed the progression of his coronary PSA (Figure 2B). The intervention revealed a progression in the size of the known coronary PSA (Figure 3BandC, Supplementary material online, Video S2) and LCx in-stent occlusion.
(A) In July 2021, computed tomography showed a progression of the aneurysm, measured 40 x 33 x 24 mm. (B and C) Invasive coronary angiography shows the progression of the aneurysm preinterventionally.
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The intervention revealed a progression in the size of the known coronary PSA (Figure 3BandC, Supplementary material online, Video S2) and LCx in-stent occlusion. In CT, the LCx PSA measured 40 x 33 x 24 mm (Figure 3A).
(A and B) Coronary angiography displays the main steam with a covered stent, silencing the chronically occluded LCx and the aneurysm.
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After post-implantation dilatation with non-compliant balloons (NC Quantum 4.5/12 mm'' in LMCA and NC Quantum 3.5/12 mm in the LAD), a complete sealing of the coronary PSA could be achieved (Figure 4; Supplementary material online, Video S3).