Percutaneous coronary intervention employing a double drug-eluting stent sandwich strategy for a right coronary artery aneurysm with severe calcified stenosis: a case report

BACKGROUND: Coronary artery aneurysm(CAA) represents a rare subset of coronary artery disease and is associated with heightened risks of cardiovascular mortality. Because of its low prevalence, large-scale data are scarce, therefore specific therapeutic guidelines remain underdeveloped. We report the case of a 64-year-old female who presented to our hospital due to unstable angina. The coronary angiogram showed an aneurysm in the mid-segment of the right coronary artery, the arterial lumen preceded the aneurysm was severe stenosis with calcification. Considering the elevated risks of rupture and embolic events, the heart team opted for a percutaneous treatment strategy. Pre-procedural three-dimensional computed tomography(CT) reconstruction and intravascular ultrasound (IVUS) guidance facilitated the successful exclusion of the aneurysm using two drug-eluting stents.At 12-month follow-up, the patient reported no further episodes of angina. CONCLUSION: For patients with acute coronary syndrome caused by a coronary artery aneurysm culprit, percutaneous coronary intervention(PCI) is viable therapeutic option when anatomical conditions are favorable.