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Closure of an iatrogenic aortocoronary arteriovenous fistula: Transcatheter balloon embolization following failed coil embolization and salvage of coils that migrated into the coronary venous system

✍ Scribed by Lars S. Maier; Arnd B. Buchwald; Björn Ehlers; Klaus Rühmkorf; Karl H. Scholz


Publisher
John Wiley and Sons
Year
2001
Tongue
English
Weight
730 KB
Volume
55
Category
Article
ISSN
1522-1946

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✦ Synopsis


Abstract

We report a 50‐year‐old patient with successful percutaneous closure of a large inadvertent surgical aortocoronary arteriovenous fistula (shunt flow: 1.8 L/min). With initial embolization of multiple coils, no lasting occlusion of the large fistula could be achieved. Above that, two coils migrated into the coronary venous system. Following rescue of the migrated coils through a retrograde coronary sinus approach, the fistula was occluded using a detachable balloon. Follow‐up angiograms confirmed successful closure of the fistula. In contrast to coil embolization, use of a detachable balloon seems to be the appropriate technique for percutaneous closure of such fistulas. Cathet Cardiovasc Intervent 2002;55:109–112. © 2002 Wiley‐Liss, Inc.