Abstract 12850: Isolated and Assisted Transcatheter Coil Embolization of Coronary Artery Lesions: The Cleveland Clinic Experience

Abstract

Introduction: Transcatheter coil embolization (TCE) has been introduced as a modality in treating several coronary artery lesions including coronary artery fistula (CAF), patent left internal mammary artery (LIMA) side branch, coronary artery perforation (CAP), coronary artery aneurysm (CAA), and coronary artery pseudoaneurysm (CAPA) is limited. Hypothesis: TCE is underutilized in various coronary lesions despite its efficacy. Methods: This is a retrospective, descriptive study of all adult patients who underwent TCE at the Cleveland Clinic between August 2007 and August 2019. A total of 41 patients, including 25 CAF, 7 patent LIMA side branches, 5 CAP, 2 CAA, and 2 CAPA from a total of 121,196 cases, were studied. Results: Successful angiographic closure was performed in 37 out of 41 (90%) cases (100% ,100% ,100%, 88%, 80%, of patent LIMA side branch ,CAA, CAPA, CAF, CAP, respectively). Ampatzer vascular plug was used as an adjunctive device in 10% of the total cohort. No adverse events were directly associated with TCE among the LIMA, CAA, and CAPA lesions, and only one patient with CAF required re-intervention at three months due to coil migration. One patient with a large CAP of the mid-left anterior descending artery died while hospitalized due to cardiogenic shock despite successful embolization. Conclusions: Transcatheter Coil embolization in our institution was safe and effective in treating different coronary circulation abnormalities with successful angiographic results in 90% of treated cases. Additional study on the utilization of vascular plug devices in cases such as LIMA side branch or CAF would be beneficial to better understand the treatment options.