Successful application of the condom technique in closure of a large coronary aneurysm - A case report

Abstract Background Consensus regarding treatment of coronary aneurysms is lacking. The condom technique has been described as a simple technique to obtain coronary vascular occlusion in different clinical settings. We report a case of percutaneous occlusion of a large aneurysm by the condom technique. Case summary An 83-year-old male with prior ischemic heart disease presented to the emergency room after a fall with a thoracic trauma. The patient underwent extensive clinical investigation. The use of cardiac computed tomography revealed a very large right coronary artery (RCA) aneurysm. Assessing prior computed tomography angiographies, the coronary aneurysm in the RCA had grown significantly to 60 mm. A heart team recommended intervention due to a potential rupture risk. Due to patient preferences to avoid open-heart surgery and the anatomy of the aneurysm, the percutaneous coronary intervention with the condom technique was chosen to close the aneurysm with closure of the proximal part of the RCA as the RCA was chronic total occluded distally to the aneurysm. A coronary angiogram after 4 weeks showed complete closure of the aneurysm in the RCA, and the patient was doing well without adverse outcomes after four months. Conclusion This is the first case with closure of a coronary artery aneurysm by the percutaneous condom technique. The technique might be used to close aneurysms originating from chronic total occluded coronary vessels among elderly patients not eligible for open-heart surgery or other interventions. However, long-term evaluations of safety and durability are needed before recommendations can be drawn.