Coronary Artery Ectasia: An Interventional Cardiologist's Dilemma

Abstract

Coronary artery ectasia is defined as a localized, or diffuse dilation of a coronary artery lumen. Coronary artery ecta sia is well recognized, but a rare finding encountered dur ing diagnostic coronary angiography. Coronary artery ec tasia represents a form of atherosclerotic coronary artery disease, seen in 1.4-4.9% of patients undergoing coronary angiography. It may be an isolated finding, or in combination with stenotic lesions. The classification of coronary artery ectasia is divided into four groups: Type 1: Diffuse ectasia of two or three vessels, Type 2: Diffuse ectasia in one vessel and localized disease in another vessel, Type 3: Diffuse ectasia in one vessel only, and Type 4: Localized or segmental involvement. This case illuminates the difficult decision making regarding stenting of coronary arteries with ectasia and atherosclero sis. The additional challenge is whether the benefit of anti coagulation with warfarin outweighs the bleeding risk. The treatment approach is often ambiguous, and can be a vex ing clinical question, as identified in our case presentation.