CTICasesCoronary Artery Pseudoaneurysm Post-PCI
Imaging findings
Contrast-enhanced CT of the chest demonstrates a localized, contrast-filled outpouching arising from the proximal right coronary artery. A coronary stent is visible within the right coronary artery immediately adjacent to this pseudoaneurysm. No acute hemopericardium is present, suggesting the pseudoaneurysm is chronic and contained.
Key takeaways
Coronary artery pseudoaneurysm is a rare complication of percutaneous coronary intervention (PCI), typically occurring at the site of stent deployment due to focal vessel wall injury or dissection. Unlike true aneurysms, pseudoaneurysms represent a contained rupture bounded by adventitia or surrounding thrombus, carrying a higher risk of rupture and hemopericardium. In asymptomatic patients with multiple comorbidities and stable, chronic imaging appearances, conservative management with close imaging surveillance is often preferred over high-risk re-do surgical intervention.
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