Intervention with a handmade closed-loop balloon stent for a pulmonary artery fistula not closed by coil
Rukiye Gönen Özdemir, Çağlar AlpAbstract
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.