Intercostal Artery Aneurysmosis Secondary to Chronic Cocaine Abuse

Intercostal artery aneurysms are rare entities usually seen in connective tissue disorders and inflammatory conditions and syndromes like Ehlers-Danlos syndrome, Kawasaki’s disease, and neurofibromatosis. Spontaneous development of intercostal aneurysm is rare and the presence of multiple aneurysms/aneurysmosis is exceedingly rare. Although there have been a few case reports on aortic aneurysm, coronary artery aneurysms and many on ruptured cerebral aneurysms, we could not find a single case of spontaneous intercostal artery aneurysm secondary to chronic cocaine abuse. We report an exceedingly rare case of intercostal artery aneurysmosis presumably secondary to long-term cocaine abuse. Intercostal artery aneurysm is the least common visceral aneurysm and given the very limited literature on this subject, the pathogenesis is poorly understood.