{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:10:06Z","timestamp":1756311006072,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,26]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>A coronary artery aneurysm (CAA) is an uncommon clinical finding with an incidence of &lt;5% in adults. The presence of a large intracoronary thrombus within an aneurysmal coronary artery and normal coronary flow is usually a very challenging case scenario. Here, we present a case of a patient presenting with typical chest pain symptoms, high-risk findings on a pharmacological nuclear stress test and coronary angiogram showing severe multivessel coronary artery disease, including a large aneurysmal segment within the proximal left anterior descending artery with a large thrombus that did not affect intracoronary flow. Today, there are no published guidelines for the management of CAA with a normal intracoronary flow. The approach used in this case was initial antithrombotic therapy followed by a successful staged percutaneous coronary intervention. Here, we present a case supporting the use of combined intravenous anticoagulant and antiplatelet therapy for 48\u2009hours, followed by successful percutaneous intervention guided by intravascular ultrasound.<\/jats:p>","DOI":"10.1136\/bcr-2021-245219","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T12:09:51Z","timestamp":1638274191000},"page":"e245219","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of a large intraluminal thrombus in an aneurysmal coronary segment with normal coronary flow"],"prefix":"10.1136","volume":"14","author":[{"given":"Alejandro","family":"Herrera","sequence":"first","affiliation":[{"name":"Internal Medicine, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5174-1349","authenticated-orcid":false,"given":"Carlos Felipe","family":"Matute Martinez","sequence":"additional","affiliation":[{"name":"Internal Medicine, Texas Tech University Health Sciences Center School of Medicine, Odessa, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Fernando","family":"Toledo Martinez","sequence":"additional","affiliation":[{"name":"Universidad Cat\u00f3lica de Honduras Nuestra Se\u00f1ora Reina de la Paz, Facultad de medicina y cirugia, San Pedro Sula, Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan","family":"Beall","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Department, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"2025082708470747000_14.11.e245219.1","doi-asserted-by":"publisher","DOI":"10.1177\/014107688007300215"},{"key":"2025082708470747000_14.11.e245219.2","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/0002-9149(69)90500-1","article-title":"Bougon on coronary aneurysm (1812)","volume":"24","author":"Jarcho","year":"1969","journal-title":"Am J Cardiol"},{"key":"2025082708470747000_14.11.e245219.3","article-title":"Aneurysmal coronary artery disease: an overview","volume":"2017","author":"ElGuindy","year":"2017","journal-title":"Glob Cardiol Sci Pract"},{"key":"2025082708470747000_14.11.e245219.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.02.041"},{"key":"2025082708470747000_14.11.e245219.5","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.acvd.2019.10.008","article-title":"Giant coronary aneurysms, from diagnosis to treatment: a literature review","volume":"113","author":"Pham","year":"2020","journal-title":"Arch Cardiovasc Dis"},{"key":"2025082708470747000_14.11.e245219.6","first-page":"283","article-title":"Coronary artery aneurysms in acute coronary syndrome: case series, review, and proposed management strategy","volume":"26","author":"Boyer","year":"2014","journal-title":"J Invasive Cardiol"},{"key":"2025082708470747000_14.11.e245219.7","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1016\/j.amjcard.2013.02.027","article-title":"Safety and efficacy of intense antithrombotic treatment and percutaneous coronary intervention deferral in patients with large intracoronary thrombus","volume":"111","author":"Echavarr\u00eda-Pinto","year":"2013","journal-title":"Am J Cardiol"},{"key":"2025082708470747000_14.11.e245219.8","doi-asserted-by":"crossref","first-page":"e91","DOI":"10.1016\/j.athoracsur.2018.12.035","article-title":"Alternative approach for the surgical treatment of left main coronary artery aneurysm","volume":"108","author":"De Hous","year":"2019","journal-title":"Ann Thorac Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-245219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:47:14Z","timestamp":1756309634000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-245219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":8,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,30]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bcr-2021-245219"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-245219","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}