Outcomes of transcatheter closure for coronary artery fistulas with or without aneurysm: A comparative study

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-09-18 DOI:10.1002/ccd.31235

Peijian Wei MD, Zuo Pu MD, Jeffrey S. K. Chan MBChB, MPH, Yihang Li MM, Liang Xu MD, Junyi Wan MD, Fengwen Zhang MD, Gary Tse MD, PhD, Shouzheng Wang MD, Wenbin Ouyang MD, Gejun Zhang MD, Fang Fang MD, Xiangbin Pan MD, PhD

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Abstract

Background

Coronary Artery Fistulas (CAFs) Patients with aneurysm may face severe complications, necessitating prompt treatment. However, data on the outcomes of transcatheter closure in CAFs patients with aneurysm are notably scarce.

Methods

This retrospective study included all consecutive CAFs patients who underwent transcatheter closure at Fuwai Hospital from January 2010 to December 2023. Patients were divided into two groups based on the presence of aneurysm, and baseline characteristics, anatomical features, and transcatheter closure outcomes were further compared.

Results

The study ultimately included 104 patients, consisting of 56 in the aneurysm group and 48 in the non-aneurysm group. Patients in the aneurysm group were younger [39.79 (16.35) versus 50.69 (13.31) years, p < 0.001] and more frequently present with heart murmurs (21.43% vs. 6.25%, p = 0.03). Multivariate logistic regression indicated that a larger fistula diameter and the presence of CCFs are independent risk factors for the presence of aneurysm in CAF patients. The procedural success rate (75% vs. 75%, P = 1), fistula recanalization rate (11.11% vs. 16.67%, p = 0.42), and reintervention rate (3.7% vs. 6.25%, p = 0.89) were similar between the aneurysm and non-aneurysm groups.

Conclusion

A larger fistula diameters and the presence of coronary-cameral fistulas are independent risk factors for the occurrence of aneurysms in patients with CAFs. The outcomes of transcatheter closure are comparable for CAFs patients with and without aneurysm, though post-closure thrombosis within the fistula appears to be more common in patients with aneurysm.

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经导管闭合有无动脉瘤的冠状动脉瘘的疗效：比较研究

背景患有动脉瘤的冠状动脉瘘（CAFs）患者可能面临严重的并发症，需要及时治疗。方法这项回顾性研究纳入了 2010 年 1 月至 2023 年 12 月期间在阜外医院接受经导管闭合术的所有连续 CAFs 患者。根据是否存在动脉瘤将患者分为两组，并进一步比较基线特征、解剖学特征和经导管闭合结果。动脉瘤组患者更年轻[39.79（16.35）岁对 50.69（13.31）岁，P < 0.001]，更常出现心脏杂音（21.43% 对 6.25%，P = 0.03）。多变量逻辑回归表明，瘘管直径较大和存在CCF是CAF患者出现动脉瘤的独立风险因素。动脉瘤组和非动脉瘤组的手术成功率（75% vs. 75%，P = 1）、瘘管再闭合率（11.11% vs. 16.67%，P = 0.42）和再介入率（3.7% vs. 6.25%，P = 0.89）相似。有动脉瘤和无动脉瘤的CAFs患者经导管闭合的结果相当，但闭合后瘘管内血栓形成似乎在有动脉瘤的患者中更为常见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.