Korean Circ J.  2015 May;45(3):245-247. 10.4070/kcj.2015.45.3.245.

Coronary Artery Fistula with Giant Aneurysm and Coronary Stenosis Treated by Transcatheter Embolization and Stent

• Piao ZH
• Jeong MH
• Jeong HC
• Park KH
• Sim DS
• Hong YJ
• Kim JH
• Ahn Y

• KMID: 2389133
• DOI: http://doi.org/10.4070/kcj.2015.45.3.245

Abstract

Coronary artery fistula (CAF) with giant aneurysm and accompanied by coronary artery stenosis is a very rare disease. Herein, we report a case of a 76-year-old woman having a complex coronary-to-pulmonary artery fistula associated with a giant aneurysm and accompanied by coronary artery stenosis. The patient was successfully treated using transcatheter coil embolization and coronary stent implantation. Eight years later, we performed a follow-up coronary angiogram, which revealed the CAF and the aneurysm were completely occluded and previous stent patency.

Keyword

Arteriovenous fistula; Coronary aneurysm; Embolization, therapeutic; Therapeutics; Stents

MeSH Terms

Aged
Aneurysm*
Arteries
Arteriovenous Fistula
Coronary Aneurysm
Coronary Stenosis*
Coronary Vessels*
Embolization, Therapeutic
Female
Fistula*
Follow-Up Studies
Humans
Rare Diseases
Stents*

Figure

• 

  Fig. 1 Left coronary artery angiography demonstrates a giant coronary aneurysm (arrowhead) originating from a branch (black arrow) of the left anterior descending coronary artery (LAD) and severe stenosis in the mid-LAD (white arrow). A: angiography from the anterior-posterior with cranial views. B: angiography from the left-anterior-oblique views with caudal views.

• 

  Fig. 2 Percutaneous transcatheter intervention and eight year angiographic follow-up after the procedure. A: a microcatheter is advanced into the distal of the feeding artery (arrow). B: after transcatheter coil embolization (white arrow) and stent implantation (black arrow), a selective left coronary artery angiogram shows successful occlusion of blood flow to the aneurysm cavity by the coils and good distal flow without residual stenosis of left anterior descending coronary artery. C: follow-up coronary angiogram eight years after the procedure showing the aneurysm is completely occluded and well-maintained patency despite mild stenosis at the implanted stent.

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