Giant coronary aneurysms, from diagnosis to treatment: A literature review

Coronary aneurysms are classically defined as a segment of the artery in which dilation exceeds the diameter of an adjacent portion (considered as a reference point) by more than 1.5times. In rare instances, coronary artery aneurysms are large enough to be called giant coronary artery aneurysms, which have been reported as occurring with an incidence of 0.02%. However, there is no clear consensus on how giant coronary artery aneurysms should be defined, and their aetiology is not entirely clear; many causes have been suggested, with atherosclerosis being the most common among adults, accounting for up to 50% of cases, and paediatric diseases, such as Kawasaki disease and Takayasu arteritis, being the other main aetiology. Although giant coronary artery aneurysms are often incidental findings, many complications, such as local thrombosis, distal embolization, rupture and vasospasm, associated with ischaemia, heart failure and arrhythmias, have been reported. The optimal medical, interventional or surgical management, still needs to be clarified. This literature review aims to summarize current knowledge on giant coronary artery aneurysms.