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Transcatheter Coil Embolization in 17 Patients with 22 Coronary Artery Fistulas.
Texas Heart Institute Journal ( IF 0.9 ) Pub Date : 2020-06-17 , DOI: 10.14503/thij-18-6786
Ismail Ates 1 , Zeynettin Kaya 1 , Deniz Mutlu 2 , Zehra I Akyildiz 3 , Necmettin Korucuk 1 , Doruk C Karaaslan 4 , Sibel Kulaksizoglu 5 , Mehmet Cilingiroglu 6
Affiliation  

Coronary artery fistulas are rare anomalies that often become symptomatic with age. They are typically diagnosed incidentally during coronary angiography. The chief nonsurgical treatment is transcatheter coil embolization. We evaluated the outcomes of this procedure in 17 symptomatic patients who had 22 fistulas in total.

The 9 men and 8 women (mean age, 52 ± 16.5 yr; range, 27–74 yr) presented at 4 Turkish hospitals from October 2008 through March 2015. Three patients had multiple fistulas. Twelve fistulas originated from the right coronary artery and 10 from the left coronary artery, draining into the pulmonary artery in 18 instances. We evaluated results postprocedurally and after 2 to 5 months, defining angiographic success as a flow better than Thrombolysis in Myocardial Infarction grade 2 in the treated artery.

Twenty-one of the 22 procedures immediately produced the targeted flow. We observed 2 minor and no major complications. On follow-up, 3 symptomatic patients underwent successful repeat treatment of one fistula each. We found that transcatheter coil embolization afforded good success rates with few complications in closing coronary artery fistulas. We share our experience to add to the data on treating patients with coronary artery fistulas, and to raise awareness among clinicians.



中文翻译:

17 例 22 例冠状动脉瘘患者的经导管线圈栓塞术。

冠状动脉瘘是罕见的异常,通常随着年龄的增长而出现症状。它们通常是在冠状动脉造影期间偶然被诊断出来的。主要的非手术治疗是经导管线圈栓塞。我们评估了 17 名共有 22 个瘘管的有症状患者的手术结果。

9 名男性和 8 名女性(平均年龄,52 ± 16.5 岁;范围,27-74 岁)于 2008 年 10 月至 2015 年 3 月在 4 家土耳其医院就诊。三名患者有多处瘘管。12 根瘘管起源于右冠状动脉,10 根瘘管起源于左冠状动脉,在 18 例中流入肺动脉。我们在术后和 2 至 5 个月后评估了结果,将血管造影成功定义为在治疗动脉的 2 级心肌梗塞中的血流优于溶栓。

22 个程序中的 21 个立即产生了目标流。我们观察到 2 个轻微的并发症,没有严重的并发症。在随访中,3 名有症状的患者均成功地重复治疗了 1 个瘘管。我们发现经导管线圈栓塞术在关闭冠状动脉瘘方面具有良好的成功率且并发症很少。我们分享我们的经验,以增加治疗冠状动脉瘘患者的数据,并提高临床医生的认识。

更新日期:2020-08-23
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