Coronary Ectasia: Prevalence, Angiographic Characteristics and Clinical Outcome

Background/Aim: Coronary artery ectasia (CAE) is defined as diffuse dilation of the coronary arteries and differs from coronary aneurysms by being non-localized. The condition is rare, often associated with atherosclerosis, and poses significant management challenges due to its unclear pathophysiology and varied clinical presentations. The study aims to provide insights into the hospital's experience with CAE and evaluate its prognostic factors. Materiels and methods: This retrospective study evaluated 28 patients with CAE from 1692 individuals who underwent coronary angiography between January 2021 and January 2024. Patients with other heart conditions were excluded. CAE diagnosis was based on coronary artery dilation ≥1.5 times the adjacent normal segment. Data on clinical characteristics, myocardial perfusion, and stenosis were collected, and coronary lesions were classified using the Markis classification system. Results: CAE was observed in 1.65% of the study population, with most patients being male smokers, averaging 55 years of age. Of the CAE patients, 74% had significant lesions, 59% had multi-vessel involvement, and 25% presented with spontaneous thrombosis. Left ventricular dysfunction was noted in 60% of patients. Pharmacologic treatments included aspirin for all, while 9 patients also received anticoagulation therapy. Percutaneous coronary intervention (PCI) was conducted in select cases with thrombus formation or significant stenosis. Conclusion: CAE remains a poorly understood condition with a significant thrombotic risk. Atherosclerosis was the predominant cause, and management strategies, especially for thrombosis, remain individualized. Optimal treatment is still unclear, and large multicenter studies are needed to develop better treatment guidelines for CAE patients.