Percutaneous endovascular occlusion of symptomatic coronary arteriovenous fistulas with cyanoacrylate.
We describe four cases with symptomatic coronary artery fistulas that were treated primarily with endovascular cyanoacrylate embolization. Coils were also used as adjunctive embolic agents in two of these cases. All four cases showed symptomatic improvement after closure of the fistulas. Complications occurred in three cases including transient ST-segment elevation in one, symptomatic pulmonary embolization in a second, and transient pleuritic chest pain, pericarditis and acute renal failure in a third. The technical aspects of all four cases are given together with a review of the use of cyanoacrylate as an embolic material. We conclude that cyanoacrylate embolization could be considered as an alternative technique for the endovascular closure of coronary artery fistulas but must also caution that the use of this embolic agent is hazardous and should be restricted to practitioners experienced in its usage.
Duncan
Ian C
IC
Unitas Interventional Unit, P.O. Box 14031, Lytleton, Gauteng, 0140 South Africa. docdunc@iafrica.com
Gebka
Marek
M
Hellig
Farrell
F
Cilliers
Antoinette
A
Klug
Eric
E
Harrisberg
Jeffrey R
JR
Govendrageloo
Kenny
K
Middlemost
Shirley J
SJ
D058186:Acute Kidney Injury / Q000209:etiology; D000368:Aged; D001164:Arteriovenous Fistula / Q000628:therapy*; D006328:Cardiac Catheterization; D002637:Chest Pain / Q000209:etiology; D002675:Child, Preschool; D003324:Coronary Artery Disease / Q000628:therapy*; D003487:Cyanoacrylates / Q000009:adverse effects / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000209:etiology; D011655:Pulmonary Embolism / Q000209:etiology; D016896:Treatment Outcome
D003487:Cyanoacrylates