Korean Circ J.  2004 Jun;34(6):610-614. 10.4070/kcj.2004.34.6.610.

Stent Graft for a Coronary Arteriovenous Fistula in Acute Myocardial Infarction

• Kim HG
• Jeong MH
• Kim W
• Park JC
• Lee JS
• Hong YJ
• Park HW
• Lim JH
• Park OY
• Kim JH
• Kim W
• Ahn YK
• Cho JG
• Park JC
• Kang JC

• KMID: 1858911
• DOI: http://doi.org/10.4070/kcj.2004.34.6.610

Abstract

The stent graft has recently been used for the treatment of coronary artery aneurysms, perforations, dissection and arteriovenous fistula. An 81-year-old male presented with chest pain of 2-day duration. A 12-lead electrocardiogram showed atrial fibrillation and ST-T changes over the precordial leads. A diagnostic left coronary angiogram (CAG) revealed critical stenosis in the proximal left anterior descending coronary artery (LAD) and prestenotic dilatation with large coronary arteriovenous fistula draining into the main pulmonary artery. After predilation, a polytetrafluoroethylene (PTFE) covered stent graft (3.0x16 mm JoStent Graft Master(r), JoMed, Germany) for fistula and an additional conventional stent for just below the graft stented site of proximal LAD stenosis were implanted successfully. After stenting, no visible large fistula or remaining stenosis was demonstrated on CAG. The stent graft was deployed with a high success rate. The restenosis rate was not higher than expected for bare stents. However, as subacute occlusion may occur more frequently, long-term ticlopidine or clopidogrel treatment should be required.

Keyword

Stents; Grafts; Coronary disease; Fistula; Myocardial infarction

MeSH Terms

Aged, 80 and over
Aneurysm
Arteriovenous Fistula*
Atrial Fibrillation
Blood Vessel Prosthesis*
Chest Pain
Constriction, Pathologic
Coronary Disease
Coronary Vessels
Dilatation
Electrocardiography
Fistula
Humans
Male
Myocardial Infarction*
Polytetrafluoroethylene
Pulmonary Artery
Stents*
Ticlopidine
Transplants
Polytetrafluoroethylene
Ticlopidine