[Percutaneous occlusion with coils of coronary artery fistulas in adults]. / Fístulas de arterias coronarias en adultos. Oclusión percutánea mediante coils.

Coronary artery fistulas are one of the most common congenital anomalies of the coronary arteries. Most fistulas are small and of no clinical significance, although larger or multiple fistulas can be symptomatic and produce complications. Early percutaneous occlusion is now always recommended, and surgical closure is restricted to use for multiple or large fistulas. Here we report four cases of coronary fistula draining from the coronary arteries to the pulmonary vascular bed, which were treated with percutaneous occlusion by coils.

Fístulas de arterias coronarias en adultos. Oclusión percutánea mediante coils / Percutaneous occlusion with coils of coronary artery fistulas in adults

La fístula arterial coronaria es una de las anomalías congénitas más frecuentes de las arterias coronarias. Las fístulas coronarias suelen ser pequeñas y sin significación clínica, pero las más grandes pueden causar síntomas y llegar a producir complicaciones. Actualmente, se recomienda siempre su cierre temprano percutáneo, reservando la cirugía para las fístulas múltiples o de gran tamaño. Presentamos 4 casos de fístulas coronarias que drenaban en el territorio vascular pulmonar tratadas mediante oclusión percutánea con coils

Coronary artery fistulas are one of the most common congenital anomalies of the coronary arteries. Most fistulas are small and of no clinical significance, although larger or multiple fistulas can be symptomatic and produce complications. Early percutaneous occlusion is now always recommended, and surgical closure is restricted to use for multiple or large fistulas. Here we report four cases of coronary fistula draining from the coronary arteries to the pulmonary vascular bed, which were treated with percutaneous occlusion by coils

[Transradial approach for percutaneous coronary stenting in the treatment of acute myocardial infarction]. / Vía transradial en el tratamiento percutáneo del infarto agudo de miocardio con stents coronarios.

INTRODUCTION AND OBJECTIVE: Treatment of acute myocardial infarction by percutaneous coronary intervention with stenting leads to excellent immediate clinical results and a good prognosis. The aim of this study was to compare in this selected population the safety and effectiveness of radial artery access versus femoral artery access. PATIENTS AND METHOD: Between May 2001 and June 2003, 162 consecutive patients with acute myocardial infarction < 12 hours treated by percutaneous stenting were included in an observational study. The radial artery approach was used in 103 patients, and the femoral artery approach in the remaining 59 patients. The success of the procedure, incidence of major adverse cardiac events and local puncture complications were compared in patients treated with the radial artery versus the femoral artery approach. RESULTS: Fluoroscopy time (22.4 [15.4] min vs 24.5 [19.5] min), immediate success of the procedure (96.1% vs 94.9%), and the incidence of major adverse cardiac events (6.8% vs 8.5%) did not differ between the two groups. Bleeding complications due to local puncture were present only in the femoral artery access group (0 vs 5 patients; P= .007). CONCLUSIONS: In selected patients with acute myocardial infarction treated with primary stent implantation, the success rate and clinical safety of the radial artery approach are similar to those of the femoral artery approach, but the incidence of local complications, especially bleeding, is significantly lower in the former. Thus the radial artery approach should become the approach of choice in patients at high risk for bleeding complications.