Percutaneous Coil Embolization of Coronary Artery Fistula Complicated by Refractory Ventricular Fibrillation and Cardiogenic Shock

Ahmad, Abdullahi; Akhtar, Yasir

doi:10.1016/j.jaccas.2022.03.022

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The authors' experience, as well as experience in previously published literature, demonstrate that the use of a microcatheter through a 6 Fr or 7 Fr sheath, and the use of a coronary guidewire, may be sufficient to perform a successful percutaneous coil closure. 9,10 As a case series manuscript, there are some limitations to declare. The first is due to the low incidence of the disease, which means that no large, randomised studies with statistic power are feasible.…”

Section: Discussionmentioning

confidence: 99%

Should Coronary Artery Fistula Be Treated? A Review Throughout a Case Series

Buitrago-Gomez,

Salazar,

Sarmiento

et al. 2024

EMJ Int Cardiol

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Background: Coronary artery disease (CAD) includes a wide spectrum of entities beyond the atherosclerotic disease. Coronary artery fistulas (CAF) represent an uncommon vascular abnormality that may cause several cardiovascular complications and symptoms, due to the coronary steal phenomena. Surgical or percutaneous closure should always be considered. The authors present a case series of patients with CAFs who developed cardiovascular manifestations, and underwent percutaneous closure safely and feasibly, with good clinical results. Case Summary: Five patients with CAFs were treated from 2021–2023; three were male (60%), the mean age was 59 years, the most common symptom was chest pain, and two patients presented in the context of unstable angina. The authors documented pulmonary hypertension in three patients, none of them with haemodynamic compromise of right ventricle. Two of the patients had documented ischaemia or haemodynamic significance due to the CAF. Finally, in two cases, no CAD was noted in coronary angiography. Percutaneous closure was done using a 6 Fr or 7 Fr sheath; guiding catheter 6 or 7 Fr through a workhorse guidewire, a microcatheter was placed in the coronary origin of the fistula, closure was done using a liquid embolisation system or delivering coils into the defect. The number and length of coils may vary depending on the fistula’s size. Discussion: The authors present five successful cases of percutaneous closure of symptomatic CAF, who presented with angina or dyspnoea as main symptoms. Once the diagnosis was made and further studies performed, the closure was decided based on the pulmonary hypertension or coronary steal phenomena.

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Section: Discussionmentioning

confidence: 99%