Fan T, et al. – In this study, researchers conducted morphometric and hemodynamic analyses in epicardial coronary arteries of patients coronary artery aneurysms (CAAs) induced by atherosclerosis. To enhance the risk evaluation of CAAs, they proposed a two-step analysis method—ie, coronary artery bifurcation is the major risk factor for CAA followed by high aneurysm shape index (L/W, where L and W refer to the aneurysm length and maximum diameter, respectively). Compared with those who have CAA in one vessel, a higher occurrence of myocardial ischemia relevant to abnormal hemodynamic parameters was evident in patients with CAA covering a bifurcation. The worst hemodynamic environment was observed in patients with CAA of L/W ≥ 2 covering a bifurcation. The two-step analysis method was supported by morphometric and hemodynamic studies. In all, this method may offer clinical rationale for the noninvasive evaluation of CAAs.