First Case Report of Simultaneously Detected Celiac and Cerebral Artery Aneurysms in a Patient with Myocardial Infarction

A 48-year-old gentleman was admitted to our cardiovascular center due to abrupt, new-onset anginal pain about 1 hour before presentation. Two-dimensional echocardiography showed myocardial infarction in the left circumflex coronary artery territory. The coronary angiogram showed chronic total occlusion in the distal left circumflex coronary artery, significant stenoses in the proximal and middle left anterior descending coronary arteries, and at obtuse marginal branch (Fig. 1A) which were treated with zotarolimus-eluting stent deployments (Fig. 1B–D). Follow-up coronary angiography showed no evidence of stent failure (Fig. 1E, F). For the evaluation of the patient's epigastric pain, a computed tomography was done. There was a fusiform aneurysm at the celiac axis (Fig. 2A). Patient also complained of headache so a brain magnetic resonance imaging was also evaluated. The brain magnetic resonance imaging showed a 3 mm-sized saccular aneurysm at the bifurcated area of right middle cerebral artery (Fig. 2B) and an elective clipping operation was done (Fig. 2C, D).

FIG. 1. (A) Coronary angiogram revealed chronic total occlusion in the distal left circumflex artery, and severe stenoses in the proximal and middle left anterior descending artery and obtuse marginal branch (black arrowheads). (B, C) Zotarolimus-eluting stents were deployed for each lesion (white arrows) and (D) the final angiogram showed good results. (E, F) Follow-up angiogram showed no stent failure (white arrows).

FIG. 2. (A) Computed tomography showed a fusiform aneurysm at the celiac axis (white arrow). (B) Brain magnetic resonance imaging showed a saccular aneurysm at the bifurcation area of middle cerebral artery (white arrow). (C, D) Elective clipping operation was performed.

Celiac artery aneurysms are a very rare disease, accounting for less than 4% in the overall splanchnic artery aneurysms.1 The prevalence of cerebral aneurysm is estimated to be approximately 3.2%.2 To the best of our knowledge, this is the first case of celiac artery aneurysm and cerebral aneurysm simultaneously detected in a patient with a myocardial infarction who underwent multivessel stent implantation.