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BackgroundCoronary bronchial artery fistulas (CBFs) are rare anomalies, which may be isolated or associated with other disorders.Materials and methodsTwo adult patients with CBFs are described and a PubMed search was performed using the keywords “coronary bronchial artery fistulas” in the period from 2008 to 2013.ResultsTwenty-seven reviewed subjects resulting in a total of 31 fistulas were collected. Asymptomatic presentation was reported in 5 subjects (19 %), chest pain (n = 17) was frequently present followed by haemoptysis (n = 7) and dyspnoea (n = 5). Concomitant disorders were bronchiectasis (44 %), diabetes (33 %) and hypertension (28 %). Multimodality and single-modality diagnostic strategies were applied in 56 % and 44 %, respectively. The origin of the CBFs was the left circumflex artery in 61 %, the right coronary artery in 36 % and the left anterior descending artery in 3 %. Management was conservative (22 %), surgical ligation (11 %), percutaneous transcatheter embolisation (30 %), awaiting lung transplantation (7 %) or not reported (30 %).ConclusionsCBFs may remain clinically silent, or present with chest pain or haemoptysis. CBFs are commonly associated with bronchiectasis and usually require a multimodality approach to be diagnosed. Several treatment strategies are available. This report presents two adult cases with CBFs and a review of the literature.

A 69-year-old woman with stable angina pectoris was enrolled in the randomized, double-blind RAndomized study with the sirolimus-eluting VElocity balloon-expandable stent in the treatment of patients with de novo native coronary artery Lesions (RAVEL) trial. Coronary angiography revealed a proximal stenosis in the left circumflex coronary artery ( Figure 1A). A 3.0ϫ18 mm sirolimus-eluting Bx VELOCITY stent (Cordis Corp, Johnson & Johnson) was implanted with a satisfactory result ( Figure 1B). Intravascular ultrasound (IVUS) images were then obtained with ECGgated pullback, showing stent struts well apposed to the vessel wall ( Figure 1D). At 6-month follow-up, angiography showed no restenosis ( Figure 1C), whereas IVUS images revealed good stent apposition with minimal neointimal hyperplasia and some tissue disappearance between stent struts ( Figure 1E and 1F). To further evaluate these observations, we combined biplane angiography and IVUS (ANGUS) for a true 3-dimensional reconstruction of the stented region. Figure 2 shows the intimal thickness color-coded on the stent surface. The blue area seen on the proximal stent surface after the procedure (Figure 2A and 2B) relates to a side branch. The images at follow-up ( Figure 2C and 2D) identify additional blue areas, indicating disappearance of tissue between stent struts and lumen enlargement. Localized neointimal hyperplasia (red area) was also observed. In addition, there are small changes in 3D stent shape. In the RAVEL trial, the late loss averaged Ϫ0.01Ϯ0.33 mm, consistent with the presence of lumen enlargement in some patients. , and no restenosis at 6-month follow-up (C). The IVUS images show the stent well apposed to the vessel wall both after the procedure (D) and at follow-up (E). The schema of the IVUS image at follow-up (F) depicts minimal neointimal hyperplasia and the disappearance of tissue between stent struts.