CORONARY-ARTERY ECTASIA - LOCAL PATHOLOGY OR DIFFUSE DISEASE

It is not known whether general or local factors influence the pathoge nesis of coronary ectasia. We analyzed prospectively coronary angiogra ms from 2,186 consecutive patients with 32 patients (1.5%), identified as having coronary artery ectasia, Sixteen subjects had coronary ecta sia in more than one segment of the same or a different artery, In 20 of 72 (28%) ectatic segments there was a proximal, related stenosis, I n these cases ectasia was more often saccular than fusiform (16 vs, 4) compared to ectasia without a proximal, related stenosis (21 vs, 31, P = 0.003), and the mean length of the ectatic segment was shorter (8. 0 vs, 15.1 mm, P = 0.013), Subjects with ectasia after a stenosis ofte n had other ectatic segments unrelated to stenoses, The high incidence of multisegment involvement suggests that coronary ectasia results fr om a diffuse abnormality of the vessel wall, In predisposed individual s localized ectasia may follow a stenosis, suggesting poststenotic dil atation. (C) 1994 Wiley-Liss, Inc.