Cardiology in the young · 2026
Intervention with a handmade closed-loop balloon stent for a pulmonary artery fistula not closed by coil.
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Gönen Özdemir Rukiye, Alp Çağlar
Аннотация
BACKGROUND: Coronary-pulmonary artery fistulas (CPAF) are rare anomalies that may cause coronary steal and clinical symptoms. Coil embolisation is often effective, but residual flow can persist in large fistulas.
CASE: A 70-year-old male with coronary artery disease underwent coil embolisation for a right coronary-pulmonary artery fistula. Residual flow persisted, leading to exertional dyspnoea. Coronary angiography confirmed incomplete closure. Since a vascular plug was unavailable, a closed-loop balloon-stent technique was performed with guideliner support, achieving complete occlusion.
RESULTS: The fistula was successfully closed, eliminating the pathological connection. At 6-month follow-up, dyspnoea had resolved.
CONCLUSIONS: This case highlights the limitations of coil embolisation in large CPAF and demonstrates the safety and efficacy of a guideliner-assisted closed-loop balloon-stent technique as a practical alternative when plugs are unavailable.
CASE: A 70-year-old male with coronary artery disease underwent coil embolisation for a right coronary-pulmonary artery fistula. Residual flow persisted, leading to exertional dyspnoea. Coronary angiography confirmed incomplete closure. Since a vascular plug was unavailable, a closed-loop balloon-stent technique was performed with guideliner support, achieving complete occlusion.
RESULTS: The fistula was successfully closed, eliminating the pathological connection. At 6-month follow-up, dyspnoea had resolved.
CONCLUSIONS: This case highlights the limitations of coil embolisation in large CPAF and demonstrates the safety and efficacy of a guideliner-assisted closed-loop balloon-stent technique as a practical alternative when plugs are unavailable.