Related Experiment Video
Updated: May 12, 2026
Myocardial Infarction by Percutaneous Embolization Coil Deployment in a Swine Model
Published on: November 4, 2021
Transcatheter coil embolization in coronary artery fistulae
Budi Y Setianto1, Pudya L Arshant
1Department of Cardiology and Vascular Medicine, Gadjah Mada University-dr. Sardjito Hospital. Jl. Kesehatan Sekip no. 1, Yogyakarta, Indonesia. budyuls@yahoo.com
Insights
Coronary artery fistulae (CAF) can cause chest pain and are treated with transcatheter coil embolization (TCCE). This minimally invasive procedure effectively resolved symptoms in a patient with a left anterior descending artery fistula to the right atrium.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Anomalies
Background:
- Coronary artery fistulae (CAF) are rare vascular anomalies with varying incidence rates.
- Symptomatic or high-flow shunting CAF often require intervention, including surgical or transcatheter approaches.
- Transcatheter coil embolization (TCCE) is a recognized non-surgical treatment option for CAF.
Observation:
- A 63-year-old female presented with persistent chest pain.
- Coronary angiography revealed a 95% narrowing of the left anterior descending (LAD) artery and a CAF from the LAD into the right atrium.
- Percutaneous coronary intervention (PCI) with drug-eluting stents for LAD stenosis did not alleviate chest pain.
Findings:
- The patient underwent transcatheter coil embolization (TCCE) for the coronary artery fistula.
- Following TCCE, the patient's chest pain resolved.
- Post-procedure ECG evaluation returned to normal limits.
Implications:
- Transcatheter coil embolization (TCCE) is an effective treatment for symptomatic coronary artery fistulae (CAF) that persist after addressing significant coronary artery disease.
- Minimally invasive TCCE can successfully resolve chest pain associated with complex coronary artery anomalies.
- This case highlights the importance of considering and treating concurrent coronary artery disease and fistulae for comprehensive symptom management.
Abstract:
Coronary artery fistulae (CAF) is a rare anomaly, mostly with the incidence of congenital CAF 0.1% - 0.2% and the incidence of acquired CAF 0.2% at coronary angiography. Symptomatic or high flow shunting CAF must be treated with surgery or non surgery approach such as transcatheter coil embolization (TCCE). A women 63 years old with chief complain of chest pain since one month ago. The patient had undergone coronary angiography with conclusions as follows 95% narrowing of proximal LAD (left anterior descendens) artery and CAF from LAD into the right atrium. Whereas narrowing of proximal LAD was performed PCI (percutaneous coronary intervention) with the implantation of drug eluting stents, but patients still complained chest pain. CAF decided to do the TCCE. Post TCCE chest pain and ECG evaluation were within normal limits.
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:27Coronary Artery Disease V: Interprofessional Care
01:24Cardiac Catheterization III: Left Heart Catheterization
01:27Peripheral Artery Disease III: Interprofessional Care