Coronary artery aneurysm: A review.

Coronary artery aneurysm: A review.
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冠状动脉瘤:综述。

DOI:
10.4330/wjc.v13.i9.446
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发表时间:
2021-09-26
影响因子:
1.9
通讯作者:
Roncalli J
Roncalli J
中科院分区:
其他
文献类型:
--
作者:
Matta AG;Yaacoub N;Nader V;Moussallem N;Carrie D;Roncalli J

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冠状动脉瘤(CAA)是一种临床实体,定义为冠状动脉的局灶性扩大超过相邻正常段直径的1.5倍。动脉粥样硬化是成人的主要病因,川崎是儿童的主要病因。CAA是冠状动脉造影偶然发现的一种无症状的进行性疾病,但它可能以致命的并发症结束,如破裂、邻近心肺结构的压迫、血栓形成和远端栓塞。其病理生理机制尚未完全了解。动脉粥样硬化、蛋白水解失衡和炎症反应参与了动脉粥样硬化的形成。来自先前发表的研究的数据是稀缺的和有争议的,因此CAA的管理是个性化的,这取决于临床表现,CAA的特点,患者的个人资料和医生的经验。描述了多种治疗方法,包括药物治疗、覆膜支架成形术、弹簧圈插入和手术。在此,我们提供了一个最新的系统审查的病理生理学,并发症和管理CAA。
Coronary artery aneurysm (CAA) is a clinical entity defined by a focal enlargement of the coronary artery exceeding the 1.5-fold diameter of the adjacent normal segment. Atherosclerosis is the main cause in adults and Kawasaki disease in children. CAA is a silent progressive disorder incidentally detected by coronary angiography, but it may end with fatal complications such as rupture, compression of adjacent cardiopulmonary structures, thrombus formation and distal embolization. The pathophysiological mechanisms are not well understood. Atherosclerosis, proteolytic imbalance and inflammatory reaction are involved in aneurysmal formation. Data from previously published studies are scarce and controversial, thereby the management of CAA is individualized depending on clinical presentation, CAA characteristics, patient profile and physician experience. Multiple therapeutic approaches including medical treatment, covered stent angioplasty, coil insertion and surgery were described. Herein, we provide an up-to-date systematic review on the pathophysiology, complications and management of CAA.
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