Ectasies coronaires et thrombus

Ectasias and coronary aneurysms are uncommon coronary artery diseases, can coexist and are poorly known. Their principal etiology in adults is coronary atherosclerosis. It has been suggested that these abnormalities would have poor prognosis and that slow flow could lead to in situ thrombosis and distal embolisation. However, ectasias and aneurysms are most often associated with coronary stenosis. We report a series of 47 cases of ectasias and coronary aneurysms with evaluation of the clinical and angiographic characteristics, the therapeutic choices and we review the literature concerning these lesions. In situ thrombosis does not seem to be the usual pathophysiological mechanism. We retain that this is a particular form of coronary atherosclerosis in this population and present technical problems in case of revascularization with an predominant indication of medical treatment (57.4 % of the cases), but rarely the introduction of anticoagulants (4.25 % of the cases), except in acute coronary syndromes where revascularization is most common (70.6 % of cases) as is usually expected in the general population. The complex angiographic presentation of these lesions is probably an explanation for the low numbers of revascularizations performed.