Incidental aneurysms of aorta and basilar artery in patients with coronary artery ectasia. A magnetic resonance angiography study

Objective - Incidental intracranial aneurysms have been revealed in 0.5-1% of adult patients undergoing cerebral angiography, while only 8% of those aneurysms are located in the basilar artery. Those aneurysms running usually symptomless, may lead to life-threatening situations due to rupture. Intracranial aneurysms could co-exist with abdominal aneurysms. Another dilating arterial lesion, coronary artery ectasia was linked in previous studies with aneurysms of the abdominal aorta. The aim of the present study is to investigate the coexistence of coronary artery ectasia with other aneurysms since dilating arterial lesions seem to share a similar pathogenesis, a thin or absent media of the arterial wall. Methods and results - Ten consecutive patients with coronary artery ectasia after coronary angiography underwent magnetic angiography (MRA) of the brain, thoracic and abdominal aorta. Three incidental aneurysms were revealed: one intracranial aneurysm located in the basilar artery, one extended thoracic/abdominal aneurysm and one abdominal aneurysm. Embolism was used for the management of the basilar artery aneurysm while the extended aneurysm of the descending thoracic and abdominal aorta was surgically repaired in part. Conclusions - Whether our results are just a coincidence or they announce a common pathogenesis is a subject of further screening studies of the population. Nevertheless, a high index of suspicion is expected for patients with coronary ectasia about the presence of other vascular defects at different locations, especially when non-typical symptoms are mentioned.