冠状动脉肺动脉瘘的介入治疗

Percutaneous coil embolization of coronary-pulmonary artery fistula

目的分析冠状动脉肺动脉瘘(coronary-pulmonary artery fistula,CPAF)介入治疗的方法和疗效。方法选取2016年12月至2017年8月,6例在本中心就诊的CPAF患者,其中,男性2例,女性4例。年龄(61.5±5.9)岁。通过体格检查、胸片、超声心动图、心电图及冠状动脉造影明确诊断,在本中心对其CPAF进行介入治疗。术后随访(5.5±2.8)个月。结果 6例患者中单发CPAF 2例,多发CPAF 4例,累及左冠状动脉及右冠状动脉均为5例,伴动脉瘤形成4例。6例患者中3例经桡动脉行介入治疗,3例经股动脉途径行介入治疗,共使用Boston Scientific可解脱带纤维毛弹簧圈19枚,弹簧圈直径(7.0±3.3)mm,弹簧圈长度(15.5±9.1)cm。6例患者靶血管均栓塞成功,无残余分流。随访期内无严重并发症。结论使用可解脱带纤维毛弹簧圈栓塞CPAF安全、有效,提高了CPAF的介入治疗成功率。

Objectives To evaluate the efficacy of percutaneous coil embolization of coronary-pulmonary artery fistula(CPAF).Methods Totally 6 patients with CPAF(including 4 male and 2 female patients)from December 2016 to August 2017 were collected.General examination,X-ray,echocardiogram,electrocardiogram and coronary angiography were used to diagnose CPAF.The patients were treated with percutaneous coil embolization and followed up for 3 to 10 months.Results Among the 6 patients,2 cases were single CPAF,4 cases were multiple CPAF.Fistulas in 5 patients were located in the left coronary artery,and the right coronary artery.And there were 4 cases with coronary aneurysm.All the CPAF were embolized with Interlock Fibered Occlusion System(Boston Scientific).A total of 19 coils were used.The diameter of the coil was(7.0±3.3)mm,and the length of the coil was(15.5±9.1)cm.Technical success was achieved in all patients.There was no residual shunt and serious complications.Conclusions Interlock Fibered Occlusion System is safe and effective in CPAF.And it can also improve the success rate of interventional therapy for CPAF.