Selective coronary artery fistula embolization with hystoacryl during percutaneous coronary angioplasty

The percutaneous approach to coronary artery fistula (CAF) is diverse; coils, detachable balloons and double-umbrella devices can be used. Selective embolization with hystoacryl is a novel technique that has been successfully used in patients with intracerebral arteriovenous fistulae. Hystoacryl is a resin, which on contact with the bloodstream immediately solidifies, causing complete luminal obliteration of the fistulous pathway. In the present report, we describe two cases of CAF draining into the pulmonary artery. These two cases were successfully treated with hystoacryl embolization of the fistulous pathway, during the same procedure of coronary angioplasty for localized atherosclerotic lesions in major epicardial vessels.