A Fatal Symphony of Thrombus and Turbulence: A Case of Coronary Artery Fistula with Giant Pseudoaneurysm

Yanqiu Zhang; Mengqi Tang; Xiaojing Ma; Yafeng He; Zhengchun Yu

doi:10.14744/anatoljcardiol.2026.7102

January 1, 2026The Anatolian Journal of CardiologyOpen Access

A Fatal Symphony of Thrombus and Turbulence: A Case of Coronary Artery Fistula with Giant Pseudoaneurysm

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Key Points

To describe the multimodal imaging diagnosis and successful percutaneous treatment of a coronary artery fistula complicated by an impending rupture of a giant pseudoaneurysm.
Evaluated an 80-year-old woman presenting with recurrent fatigue and amaurosis fugax using transthoracic echocardiography, myocardial contrast echocardiography, computed tomography angiography (CTA), and digital subtraction angiography.
Performed percutaneous intervention guided by optical coherence tomography, implanting 4 drug-eluting covered stents in series within the right coronary artery to cover the aneurysm neck.
Follow-up CTA on postoperative day 2 demonstrated patency of the right coronary artery stents and closure of the aneurysm with no residual flow in the thrombosed cavity.
Three-month follow-up echocardiography showed shrinkage of the aneurysm cavity with no detectable blood flow signal, accompanied by complete resolution of symptoms.

Structured PICO

P

Population

An 80-year-old woman (n=1) in China presenting with recurrent fatigue and amaurosis fugax, diagnosed with a left anterior descending and right coronary branch-to-pulmonary artery fistula, aneurysmal dilation, and a giant pseudoaneurysm in the right atrioventricular groove accompanied by mural thrombus, signs of impending rupture, and high surgical risk.

I

Intervention

Percutaneous interventional therapy with implantation of 4 drug-eluting covered stents in series within the right coronary artery, guided by optical coherence tomography.

O

Outcome

Closure of the aneurysm, stent patency, shrinkage of the aneurysm cavity, and symptom resolution over 3 months of follow-up.

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Implication

This case report demonstrates that optical coherence tomography-guided percutaneous implantation of drug-eluting covered stents can successfully treat a giant coronary artery pseudoaneurysm with impending rupture in an elderly patient at high surgical risk.

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Cite This Study

Zhang et al. (2026) studied this question.

synapsesocial.com/papers/6af74928cd1c85ac24395cdd https://doi.org/10.14744/anatoljcardiol.2026.7102

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A Fatal Symphony of Thrombus and Turbulence: A Case of Coronary Artery Fistula with Giant Pseudoaneurysm

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

A Fatal Symphony of Thrombus and Turbulence: A Case of Coronary Artery Fistula with Giant Pseudoaneurysm

Key Points

Structured PICO

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Implication

Abstract

Discussion

Cite This Study

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