P135 A CASE OF RIGHT CORONARY ARTERY ANEURYSM COMPLICATED BY ENDOVASCULAR THROMBOSIS

Abstract Coronary artery aneurysm is a rare disorder with prevalence in male population. The most commonly involved vessel the right coronary followed by anterior descending artery. frequent etiologies are atherosclerosis and Kawasaki disease. treatment of aneurysms significant stenosis often surgical, implantation covered stents case saccular aneurysms. In without stenosis, medical therapy suitable choice. Case report We present 68–year–old man history hypertension dyslipidemia, who arrived to our ED inferior STEMI. Left angiography showed 75% distal subocclusion first left marginal Right revealed severely ectatic (7–8 mm diameter) intraluminal thrombosis markedly slowed flow (TIMI 1). Considering regression symptoms ECG alterations, intracoronary bolus Tirofiban was performed i.v. infusion 24 hours association DAPT. Blood tests did not detect any relevant alterations coagulation profile but only an heterozygous mutation for MTHFR slightly altered homocysteine values. Six days later, second which confirmed persistence thrombotic formation into that treated rheolytic thromboaspiration TIMI 2 final flow. consideration angiographic findings, it decided implant stents. After multidisciplinary team discussion associate DAPT oral anticoagulant (Warfarin 5 mg, INR 2–3) patient discharged indication continue triple antithrombotic 6 months double ASA Warfarin. Conclusions context ACS caused endovascular thrombosis. Thrombolytic therapy, anticoagulation valid tools successful such cases.