电解弹簧圈介入治疗冠状动脉瘘的单中心经验——可行性、安全性分析

Interventional treatment of coronary artery fistulas by using Guglielmi detachable coils:analysis of feasibility and safety with single center experience

目的总结电解弹簧圈介入治疗冠状动脉瘘（CAF）的经验。方法回顾性分析2009年7月至2014年11月第二军医大学附属长海医院采用电解弹簧圈治疗40例CAF患者的临床资料,了解电解弹簧圈介入治疗的可行性、安全性及疗效。结果 40例患者经电解弹簧圈介入封堵均获得成功,平均植入弹簧圈（2.33±1.38）枚,未发生手术相关并发症。术中DSA造影显示12例（30%）残余分流完全消失,28例（70%）血流明显减少。术后随访1~65个月未发生再出血及缺血并发症,无相关血管狭窄、闭塞及瘘腔破裂。结论采用电解弹簧圈介入治疗CAF安全有效、疗效显著,长期疗效需进一步随访验证。

Objective To summarize the experience in treating coronary artery fistula （CAF） by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was（2.33±1.38） coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients （30%） and blood flow was significantly decreased in 28 patients （70%）. All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.