Myocardial ischemia secondary to dual coronary artery fistulas draining into main pulmonary artery

Vijayvergiya, Rajesh; Bhadauria, Prateek S.; Jeevan, Harsha; Mittal, Bhagwant Rai; Grover, Anil

doi:10.1016/j.ijcard.2008.11.074

Cited by 26 publications

(19 citation statements)

References 8 publications

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“…10,32,55,59 Many studies have demonstrated higher recanalization rates and reduced systemic exposure to the drug after IAT than experienced in patients given the drug intravenously. 53 One clinical series reports higher early recanalization rates (50%-80% of cases) compared with intravenous treatment (30%-50% of cases). 52,53 Large intracranial thrombi often resist intravenous or intraarterial administration of thrombolytic agents, and in these cases many physicians turn to intraarterial mechanical thrombectomy to achieve recanalization.…”

Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

“…53 One clinical series reports higher early recanalization rates (50%-80% of cases) compared with intravenous treatment (30%-50% of cases). 52,53 Large intracranial thrombi often resist intravenous or intraarterial administration of thrombolytic agents, and in these cases many physicians turn to intraarterial mechanical thrombectomy to achieve recanalization. These mechanical devices have gained FDA approval for tech- …”

Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

“…53 A major risk of this intervention is the occurrence of symptomatic intracranial hemorrhage following thrombolytic administration, necessitating that its use should be carefully considered in conjunction with other patient factors. 10,32,55,59 Many studies have demonstrated higher recanalization rates and reduced systemic exposure to the drug after IAT than experienced in patients given the drug intravenously.…”

Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

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Improving patient selection for endovascular treatment of acute cerebral ischemia: a review of the literature and an external validation of the Houston IAT and THRIVE predictive scoring systems

Ishkanian¹,

McCullough-Hicks²,

Appelboom³

et al. 2011

FOC

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Outcome after intraarterial therapy (IAT) for acute ischemic stroke remains variable, suggesting that improved patient selection is needed to better identify patients likely to benefit from treatment. The authors evaluate the predictive accuracies of the Houston IAT (HIAT) and the Totaled Health Risks in Vascular Events (THRIVE) scores in an independent cohort and review the existing literature detailing additional predictive factors to be used in patient selection for IAT. They reviewed their center's endovascular records from January 2004 to July 2010 and identified patients who had acute ischemic stroke and underwent IAT. They calculated individual HIAT and THRIVE scores using patient age, admission National Institutes of Health Stroke Scale (NIHSS) score, admission glucose level, and medical history. The scores' predictive accuracies for good outcome (discharge modified Rankin Scale score ≤ 3) were analyzed using receiver operating characteristics analysis. The THRIVE score predicts poor outcome after IAT with reasonable accuracy and may perform better than the HIAT score. Nevertheless, both measures may have significant clinical utility; further validation in larger cohorts that accounts for differences in patient demographic characteristics, variation in time-to-treatment, and center preferences with respect to IAT modalities is needed. Additional patient predictive factors have been reported but not yet incorporated into predictive scales; the authors suggest the need for additional data analysis to determine the independent predictive value of patient admission NIHSS score, age, admission hyperglycemia, patient comorbidities, thrombus burden, collateral flow, time to treatment, and baseline neuroimaging findings.

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Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

Section: Forms Of Iat and Existing Study Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Improving patient selection for endovascular treatment of acute cerebral ischemia: a review of the literature and an external validation of the Houston IAT and THRIVE predictive scoring systems

Ishkanian¹,

McCullough-Hicks²,

Appelboom³

et al. 2011

FOC

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“…There are multiple cases reported with different types of CAFs who underwent MPI. Obtained results range from normal stress and rest perfusion to significant ischaemia in different patients [2,8,14,15].…”

Section: Discussionmentioning

confidence: 99%

Bilateral coronary artery to pulmonary trunk fistulae detected by coronary angiography and evaluated by ECG-gated SPECT myocardial perfusion imaging: report of two cases

Pachowicz

Drozd²,

Belz

et al. 2014

Folia Morphol

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Coronary artery fistulae (CAF) are anomalies related to coronary artery abnormaltermination. This is a very rare congenital malformation accounting for about 0.2-0.4% of congenital cardiac anomalies, but in some patients it can be haemodynamically important. Single-photon emission computed tomography or positron emission tomography myocardial perfusion imaging (MPI) using radioactive agents is widely used in clinical practice for cardiac ischaemia detection as a very sensitive and non-invasive tool.We are going to present 2 patients with bilateral CAFs to the pulmonary trunk without signs of the rest or stress ischaemia in MPI. (Folia Morphol 2014; 73, 4: 514-520)

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“…Majority of these fistulas originate from the right coronary artery or the left anterior descending artery. Patients are frequently asymptomatic, but angina due to coronary steal phenomenon or myocardial infarction and dyspnea due to heart failure and endocarditis have been reported in some cases [2,3]. The management is complex, and recommendations are founded on anecdotal cases of very small retrospective series.…”

Section: Introductionmentioning

confidence: 99%

Coronary pulmonary fistula: A case series

Caenegem¹,

Vandekerckhove²

2016

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comCoronary pulmonary fistula: A case series Maarten Van Caenegem, Hans Vandekerckhove ABSTRACT Introduction: Coronary artery fistulas (CAF) are congenital or acquired coronary artery anomalies, circumventing the myocardial capillary network by directly draining the blood into a great vessel, cardiac chamber, or other vascular structure. Clinical manifestations vary considerably with presentation of dyspnea, congestive heart failure, angina, endocarditis, arrhythmias, or myocardial infarction. Case Report: We report two cases, one between the right coronary artery (RCA) and the pulmonary artery, whereas the other between the circumflex artery (RCX) and the pulmonary artery. We describe our diagnostic methodology and analyze literature on the epidemiology, the diagnostic workout and the treatment possibilities. Conclusion: Despite the role of non-invasive imaging for diagnosis and identification of the location of CAF including the origin and insertion of the recipient vessel, cardiac catheterization and coronary angiography remain the preliminary diagnostic tools for the precise allocation of coronary anatomy, for assessment of its hemodynamic importance, and to show other structural abnormalities.

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Myocardial ischemia secondary to dual coronary artery fistulas draining into main pulmonary artery

Cited by 26 publications

References 8 publications

Improving patient selection for endovascular treatment of acute cerebral ischemia: a review of the literature and an external validation of the Houston IAT and THRIVE predictive scoring systems

Improving patient selection for endovascular treatment of acute cerebral ischemia: a review of the literature and an external validation of the Houston IAT and THRIVE predictive scoring systems

Bilateral coronary artery to pulmonary trunk fistulae detected by coronary angiography and evaluated by ECG-gated SPECT myocardial perfusion imaging: report of two cases

Coronary pulmonary fistula: A case series

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