Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Department of Internal Medicine, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA.
Catheter Cardiovasc Interv. 2021 Dec 1;98(7):1317-1331. doi: 10.1002/ccd.29381. Epub 2020 Nov 18.
Determining the outcomes of transcatheter coil embolization (TCE) for several coronary artery lesions.
TCE has been used as a treatment modality for various lesions in the coronary circulation. However, data on the efficacy and safety of TCE to treat coronary artery fistula (CAF), left internal mammary artery (LIMA) side-branch, coronary artery perforation (CAP), coronary artery aneurysm (CAA), and coronary artery pseudoaneurysm (CAPA) are limited.
We conducted a retrospective, descriptive analysis of all TCE devices in coronary lesions at our center from 2007 to 2019. Forty-one studied lesions included 25 CAF, 7 LIMA side-branch, 5 CAP, 2 CAA, and 2 CAPA. Short- and 1-year mortality and hospital readmission were reported, in addition to coil-related complications and procedural success.
The utilization rate of TCE in coronary artery lesions at our center was found to be 33.8 per 100,000 percutaneous coronary intervention procedures over 12 years. Successful angiographic closure was achieved in 37 out of 41 (87.8%) cases (88, 100, 60, 100, and 100% of CAF, LIMA side-branch, CAP, CAA, and CAPA, respectively). No adverse events were directly related to TCE among the LIMA, CAA, and CAPA cases, and only one patient with CAF required reintervention at 3 months due to coil migration.
Coil embolization in our institution was safe and effective in treating different coronary circulation abnormalities with a 87.8% overall success rate. Further study on the use of vascular plug devices in cases such as CAF or LIMA side-branch would be beneficial to understand the treatment options better.
确定经导管线圈栓塞(TCE)治疗多种冠状动脉病变的结果。
TCE 已被用作治疗冠状动脉循环中各种病变的一种治疗方式。然而,关于 TCE 治疗冠状动脉瘘(CAF)、左内乳动脉(LIMA)侧支、冠状动脉穿孔(CAP)、冠状动脉瘤(CAA)和冠状动脉假性动脉瘤(CAPA)的疗效和安全性的数据有限。
我们对 2007 年至 2019 年期间在我们中心接受 TCE 治疗的所有冠状动脉病变进行了回顾性描述性分析。41 个研究病变包括 25 个 CAF、7 个 LIMA 侧支、5 个 CAP、2 个 CAA 和 2 个 CAPA。报告了短期和 1 年死亡率和住院再入院率,以及线圈相关并发症和程序成功情况。
在 12 年的时间里,我们中心 TCE 在冠状动脉病变中的使用率为每 100000 例经皮冠状动脉介入治疗 33.8 例。在 41 个病例中,有 37 个(87.8%)成功进行了血管造影性闭合(CAF、LIMA 侧支、CAP、CAA 和 CAPA 的成功率分别为 88%、100%、60%、100%和 100%)。在 LIMA、CAA 和 CAPA 病例中,没有与 TCE 直接相关的不良事件,只有 1 例 CAF 患者因线圈迁移在 3 个月时需要再次介入治疗。
在我们的机构中,线圈栓塞在治疗不同的冠状动脉循环异常方面是安全有效的,总体成功率为 87.8%。进一步研究血管塞装置在 CAF 或 LIMA 侧支等病例中的应用,将有助于更好地了解治疗选择。