Percutaneous management of coronary aneurysms: case report and evidence base perspective
| Published |
| September 1, 2025 |
| Title |
| Percutaneous management of coronary aneurysms: case report and evidence base perspective |
| Authors |
| Iginio Colaiori, Luigi Spadafora, Marco Coniglio, Giuseppe Biondi-Zoccai, Francesco Versaci |
| DOI |
| 10.62684/IDKO5197 |
| Downloads |
 |
Iginio Colaiori (a), Luigi Spadafora (a), Marco Coniglio (b), Giuseppe Biondi-Zoccai (c,d), Francesco Versaci (a)
(a) Department of Cardiology, Santa Maria Goretti Hospital, Latina, Italy
(b) Department of Radiology, Santa Maria Goretti Hospital, Latina, Italy
(c) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
(d) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy
Correspondence to: prof. Giuseppe Biondi-Zoccai, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. Email: giuseppe.biondizoccai@uniroma1.it
Abstract
Coronary artery aneurysms (CAAs) are uncommon but potentially serious findings increasingly detected through advanced coronary imaging. Their etiology is diverse, including atherosclerosis and iatrogenic injury, and their clinical implications range from benign to life-threatening. Treatment strategies vary based on aneurysm size, location, and associated symptoms, and while surgical options have been traditional, percutaneous techniques are gaining ground. We hereby report the case of a patient with an incidentally discovered aneurysm arising from a secondary branch of the proximal right coronary artery. Following heart team evaluation, coil embolization was successfully performed via femoral access using selective wiring and deployment of neurovascular coils, achieving complete exclusion of the aneurysm. We also review the current evidence supporting percutaneous options for CAA management, including covered stents, coils, vascular plugs, liquid embolics, and custom devices. While percutaneous techniques offer promising outcomes with lower procedural morbidity, high-quality comparative data are lacking. Our case highlights the feasibility and safety of coil embolization in anatomically favorable scenarios and supports the need for individualized procedural planning. Broader adoption of these strategies will require systematic data collection and consensus-driven guidelines to optimize long-term outcomes in CAA management.
Declarations
Acknowledgements
This manuscript was drafted and illustrated with the assistance of artificial intelligence tools, such as ChatGPT 4 (OpenAI, San Francisco, CA, USA), Mage (Mage, New York, NY, USA), and Napkin AI (Napkin AI, Palo Alto, CA, USA), in keeping with established best practices (Biondi-Zoccai G, editor. ChatGPT for Medical Research. Torino: Edizioni Minerva Medica; 2024). The final content, including all conclusions and opinions, has been thoroughly revised, edited, and approved by the authors. The authors take full responsibility for the integrity and accuracy of the work and retain full credit for all intellectual contributions. Compliance with ethical standards and guidelines for the use of artificial intelligence in research has been ensured.
Conflict of Interest
The Authors declare that there is no conflict of interest.
Funding
None
Disclosure
Giuseppe Biondi-Zoccai has consulted, lectured and/or served as advisory board member for Abiomed, Advanced Nanotherapies, Aleph, Amarin, AstraZeneca, Balmed, Cardionovum, Cepton, Crannmedical, Endocore Lab, Eukon, Guidotti, Innovheart, Meditrial, Menarini, Microport, Opsens Medical, Synthesa, Terumo, and Translumina, outside the present work. All other authors report no conflict of interest.
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