Stent graft treatment for coronary sinus hemorrhage associated with esophageal cancer

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Radiology

Background:

• Hemorrhage from the coronary sinus is exceptionally rare and often fatal.
• Surgical intervention has been the traditional treatment for coronary sinus rupture.
• Comorbidities can contraindicate surgery, necessitating alternative approaches.

Purpose of the Study:

• To describe the endovascular management of coronary sinus rupture in a patient with esophageal cancer and pericardial abscess.
• To evaluate the efficacy and limitations of stent graft deployment for this rare condition.

Main Methods:

• A patient with coronary sinus rupture secondary to esophageal cancer and a pericardial abscess was treated with endovascular therapy.
• Stent graft deployment was utilized to manage the hemorrhage.
• Computed Tomography (CT) was used for follow-up imaging.

Main Results:

• Endovascular stent graft deployment successfully controlled the hemorrhage initially, allowing for temporary patient discharge.
• Two months post-procedure, CT revealed occlusion of the stent graft by thrombosis.
• The patient died 2.5 months after the initial treatment due to complications, not hemorrhage.

Conclusions:

• Endovascular therapy can be a viable alternative for coronary sinus rupture in surgically high-risk patients.
• Thrombosis of the deployed stent graft is a significant complication that can lead to treatment failure.
• Further research is needed to optimize endovascular strategies for managing rare vascular emergencies like coronary sinus rupture.