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Coil Embolization of Coronary-Cameral Fistula Complicating Revascularization of Chronic Total Occlusion

Amy Mertens1, Pratik Dalal1, Michael Ashbrook1

  • 1Department of Cardiovascular Medicine, Beaumont Health System, Royal Oak, MI, USA.

Case Reports in Cardiology
|September 25, 2018
PubMed

Insights

A rare complication of chronic total occlusion percutaneous coronary intervention is coronary-cameral fistula. This case report details successful coil embolization treatment for a symptomatic left anterior descending to right ventricle fistula.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Percutaneous coronary artery intervention (PCI) for chronic total occlusions (CTO) carries risks.
  • Traumatic vessel perforation is a known, albeit infrequent, complication of CTO PCI.
  • Coronary-cameral fistulas are rare sequelae of such perforations.

Observation:

  • A patient developed a symptomatic left anterior descending (LAD) to right ventricle (RV) fistula following CTO PCI.
  • The fistula resulted from traumatic vessel perforation during the intervention.
  • The patient presented with symptoms attributable to the coronary-cameral fistula.

Findings:

  • The case highlights the potential for coronary-cameral fistula formation after CTO PCI.
  • Successful management of a symptomatic LAD-RV fistula was achieved.
  • Coil embolization was employed as the therapeutic strategy for fistula closure.

Implications:

  • This case expands the understanding of managing rare complications after complex PCI.
  • Coil embolization presents a viable treatment option for coronary-cameral fistulas.
  • Further research may elucidate optimal management strategies for these uncommon fistulas.

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