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Published on: November 4, 2021
Utilization and outcomes of transcatheter coil embolization for various coronary artery lesions: Single-center
Omar M Abdelfattah1,2, Anas M Saad1, Nicholas Kassis3
1Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Insights
Transcatheter coil embolization (TCE) is a safe and effective treatment for coronary artery fistulas, perforations, and aneurysms, achieving an 87.8% success rate. Further research into vascular plug devices for specific coronary lesions is recommended.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Transcatheter coil embolization (TCE) is utilized for various coronary circulation lesions.
- Limited data exists on TCE efficacy for coronary artery fistula (CAF), LIMA side-branch, coronary artery perforation (CAP), coronary artery aneurysm (CAA), and coronary artery pseudoaneurysm (CAPA).
Purpose of the Study:
- To determine the outcomes of transcatheter coil embolization (TCE) for diverse coronary artery lesions.
- To evaluate the safety and efficacy of TCE in treating specific coronary abnormalities.
Main Methods:
- Retrospective analysis of TCE devices used for coronary lesions between 2007 and 2019.
- Included 41 lesions: 25 CAF, 7 LIMA side-branch, 5 CAP, 2 CAA, and 2 CAPA.
- Assessed procedural success, short- and 1-year mortality, readmission, and coil-related complications.
Main Results:
- TCE utilization rate was 33.8 per 100,000 PCI procedures over 12 years.
- Overall angiographic closure success rate was 87.8% (37/41 lesions).
- High success rates for CAF (88%), LIMA (100%), CAA (100%), CAPA (100%); CAP success was 60%. No TCE-related adverse events for LIMA, CAA, CAPA; one CAF reintervention for coil migration.
Conclusions:
- TCE is a safe and effective treatment for coronary circulation abnormalities, with an 87.8% success rate.
- Further investigation of vascular plug devices for CAF and LIMA side-branch lesions is warranted.
Objective:
Determining the outcomes of transcatheter coil embolization (TCE) for several coronary artery lesions.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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