Related Experiment Video
Updated: Jun 13, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Ruptured Coronary Aneurysm With Coronary-Pulmonary Artery Fistulas in Advanced Cirrhosis Treated With Coil
Yuki Okuno1, Atsushi Nozuhara1, Taiga Matsumoto2
1Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Background:
Rupture of a coronary aneurysm (CA) associated with a coronary-pulmonary artery fistula (CPAF) is rare, and optimal management remains unclear. Patients with advanced cirrhosis have a high surgical risk.
Case Summary:
A 72-year-old woman with Child-Pugh class C cirrhosis presented with sudden chest pain. Contrast-enhanced computed tomography revealed rupture of a CA arising from bilateral CPAFs. Given the high surgical risk, transcatheter treatment was selected. Although occlusion of both inflow and outflow vessels was attempted, the outflow vessel was not accessible. After careful hemodynamic evaluation, only the main inflow vessel was embolized, achieving effective hemostasis and decompression. No re-rupture or recanalization occurred, and complete thrombosis was confirmed 3 months later.
Discussion:
CA associated with CPAF is rare and lacks established management strategies. This case highlights that inflow vessel occlusion alone may achieve life-saving hemostasis in emergency settings.
Take-Home Message:
In patients with ruptured CA associated with CPAFs, inflow vessel embolization may provide effective hemostasis.
Related Concept Videos
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Portal Hypertension
Pulmonary Embolism I: Introduction
Aneurysm III: Interprofessional Care
Pulmonary Embolism III: Nursing Management