Coil Embolisation Successfully Excludes Distal Right Coronary Aneurysm in Case Study

Interventional cardiologists have documented the successful coil embolisation of an uncommon distal coronary artery aneurysm, achieving complete exclusion of the vascular sac while preserving blood flow through the parent vessel. Detailed in a clinical report published in BMC Cardiovascular Disorders, the interventional procedure addressed an uncommon saccular aneurysm located along a distal posterolateral branch of a dominant right coronary artery.

Aneurysms that emerge within the distal branches of coronary vessels present substantial technical challenges for clinical teams. The primary therapeutic objective during intervention requires eliminating the aneurysm from active circulation while ensuring the parent artery remains fully patent to prevent ischaemic damage across the downstream myocardium. In clinical practice, aneurysms affecting the posterolateral branches of the right coronary artery are rarely documented, leaving interventional operators without standardized treatment protocols.

The clinical case involved a 62-year-old female patient who presented with a three-month history of exertional palpitations and dizziness. Diagnostic coronary angiography identified a saccular aneurysm measuring 7.6 mm by 6.4 mm originating from a posterolateral branch of her dominant right coronary artery. Angiographic assessment demonstrated that the parent vessel measured approximately 2.6 mm in diameter, while the neck of the aneurysm spanned 3.2 mm. Notably, no arterial stenosis of 50 percent or greater was detected during the diagnostic evaluation.

Extensive diagnostic workup, comprising comprehensive serological, microbiological, and computed tomographic investigations, failed to identify a specific underlying aetiology for the vascular lesion. Following multidisciplinary evaluation, clinical options including conservative surveillance, covered stent placement, surgical exclusion, and transcatheter coil embolisation were formally discussed with the patient prior to selecting an interventional strategy.

The interventional team selected selective sac embolisation, executing the procedure via a 5 French Judkins Right 4 guiding catheter alongside a 2.2 French microcatheter. Working through this catheter system, the operators deployed four detachable coils directly inside the aneurysmal lumen to promote selective occlusion without obstructing the primary arterial channel.

Completion angiography performed across two distinct projections confirmed that the coil mass remained strictly confined within the saccular pouch, showing no residual contrast filling. The parent vessel and its distal branches maintained normal Thrombolysis in Myocardial Infarction grade 3 perfusion throughout the procedure.

The patient experienced an uneventful postoperative recovery and was discharged from hospital care within 24 hours while receiving aspirin therapy. At a two-week post-procedure follow-up examination, the patient reported the complete resolution of her exertional palpitations and dizziness. However, longer-term imaging evaluations were not available at the time of reporting.

The clinicians concluded that coil embolisation achieved immediate angiographic exclusion of the distal posterolateral branch aneurysm while safely preserving both the parent vessel and distal coronary perfusion. Nevertheless, the authors emphasized that symptom causality, long-term durability of the occlusion, and comparative therapeutic benefits remain unestablished and necessitate extended clinical follow-up.

Subject of Research: Coil embolisation of a distal right coronary artery branch aneurysm

Article Title: Coil embolisation of a distal branch aneurysm of the right coronary artery with parent-vessel preservation: a case report

Article References: Xu, C., Xu, G.-X., & Jin, Y.-Q. (2026). Coil embolisation of a distal branch aneurysm of the right coronary artery with parent-vessel preservation: a case report. BMC Cardiovascular Disorders. https://doi.org/10.1186/s12872-026-06997-x

Image Credits: AI Generated

DOI: 10.1186/s12872-026-06997-x

Keywords: coronary artery aneurysm, coil embolisation, right coronary artery, posterolateral branch, interventional cardiology, parent vessel preservation, saccular aneurysm, case report, TIMI flow, cardiovascular disorders, microcatheter, detachable coils, coronary angiography, endovascular therapy, cardiac imaging, vascular exclusion