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Updated: Jan 8, 2026

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

経皮的冠動脈形成術中の冠状静脈洞への医原性冠動脈瘻の保存的治療

Tarek Mahdy¹, Mahmoud Khedr¹, Edward Hoey¹

¹University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

JACC. Case reports

|December 12, 2025

要旨

Background:

Iatrogenic coronary fistula is a rare complication during percutaneous coronary intervention.

Case Summary:

A 69-year-old woman presented with inferior ST-segment elevation myocardial infarction for which she underwent a primary percutaneous coronary intervention. During the procedure, a communication was noted between the distal right coronary artery and the coronary sinus. The patient was hemodynamically stable. She underwent a computed tomography coronary angiography and echocardiography which confirmed the diagnosis of coronary fistula. She underwent staged procedure for percutaneous coronary intervention, and the fistula flow diminished. The patient remained under follow-up and regular imaging assessment with no concerning signs or symptoms.

Discussion:

Despite its rarity, iatrogenic coronary fistula during intervention can occur due to intimal balloon inflation, guidewire perforation, and artery-balloon size mismatch.

Take-Home Messages:

The appropriate treatment for iatrogenic coronary fistula should be determined on an individual-specific basis. A detailed multimodality imaging assessment is required to determine the fistula route and its hemodynamic effect.

キーワード:

後天性症例報告合併症冠状瘻インターベンション心筋梗塞洞

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