Lee Wei-Chieh, Fang Hsiu-Yu, Wu Chiung-Jen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China.
Medicine (Baltimore). 2018 Apr;97(14):e0363. doi: 10.1097/MD.0000000000010363.
Coronary artery fistulae (CAF) are uncommon and are reported in 0.25% of patients undergoing routine coronary angiography. The combination of severe coronary artery disease and a CAF was rare.
A 76-year-old man presented unstable angina.
Coronary angiography showed a subtotal occlusion lesion and a CAF at left anterior descending artery.
The combination of transcatheter coil embolization and a drug-eluting stent was used for this problem.
The patient was symptom-free and had regularly followed up as an outpatient for three years.
The combination of a CAF and atherosclerotic change in the same site of the coronary artery is unique. It is feasible to solve the combination of CAF and severe coronary atherosclerotic lesion by transcatheter coil embolization and stent implantation. A big case series study is necessary to evaluate the safety and efficacy of the technique of transcatheter coil embolization and stent implantation in the patients with severe coronary atherosclerotic lesion and a CAF.
冠状动脉瘘（CAF）并不常见，在接受常规冠状动脉造影的患者中报告率为0.25%。严重冠状动脉疾病与CAF并存的情况罕见。
一名76岁男性出现不稳定型心绞痛。
冠状动脉造影显示左前降支动脉存在次全闭塞病变及CAF。
采用经导管弹簧圈栓塞术与药物洗脱支架相结合的方法处理该问题。
患者无症状，作为门诊患者定期随访三年。
冠状动脉同一部位出现CAF与动脉粥样硬化改变并存的情况较为独特。通过经导管弹簧圈栓塞术和支架植入术解决CAF与严重冠状动脉粥样硬化病变并存的问题是可行的。有必要开展大型病例系列研究以评估经导管弹簧圈栓塞术和支架植入术在严重冠状动脉粥样硬化病变合并CAF患者中的安全性和有效性。
