BackgroundCoronary Artery Fistulas (CAFs) Patients with aneurysm may face severe complications, necessitating prompt treatment. However, data on the outcomes of transcatheter closure in CAFs patients with aneurysm are notably scarce.MethodsThis retrospective study included all consecutive CAFs patients who underwent transcatheter closure at Fuwai Hospital from January 2010 to December 2023. Patients were divided into two groups based on the presence of aneurysm, and baseline characteristics, anatomical features, and transcatheter closure outcomes were further compared.ResultsThe study ultimately included 104 patients, consisting of 56 in the aneurysm group and 48 in the non‐aneurysm group. Patients in the aneurysm group were younger [39.79 (16.35) versus 50.69 (13.31) years, p < 0.001] and more frequently present with heart murmurs (21.43% vs. 6.25%, p = 0.03). Multivariate logistic regression indicated that a larger fistula diameter and the presence of CCFs are independent risk factors for the presence of aneurysm in CAF patients. The procedural success rate (75% vs. 75%, P = 1), fistula recanalization rate (11.11% vs. 16.67%, p = 0.42), and reintervention rate (3.7% vs. 6.25%, p = 0.89) were similar between the aneurysm and non‐aneurysm groups.ConclusionA larger fistula diameters and the presence of coronary‐cameral fistulas are independent risk factors for the occurrence of aneurysms in patients with CAFs. The outcomes of transcatheter closure are comparable for CAFs patients with and without aneurysm, though post‐closure thrombosis within the fistula appears to be more common in patients with aneurysm.

中文翻译：

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经导管封堵术治疗伴或不伴动脉瘤冠状动脉瘘的结果：一项比较研究


背景冠状动脉瘘（CAF）动脉瘤患者可能面临严重的并发症，需要及时治疗。然而，关于合并动脉瘤的 CAFs 患者经导管封堵术的结果数据明显缺乏。方法本回顾性研究纳入了 2010 年 1 月至 2023 年 12 月在阜外医院接受经导管封堵术的所有连续 CAFs 患者。根据是否存在将患者分为两组进一步比较了动脉瘤的基线特征、解剖特征和经导管封堵结果。结果该研究最终纳入了 104 名患者，其中动脉瘤组 56 名，非动脉瘤组 48 名。动脉瘤组患者更年轻[39.79 (16.35) vs 50.69 (13.31) 岁，p < 0.001]，并且更频繁地出现心脏杂音（21.43% vs. 6.25%，p = 0.03）。多变量logistic回归表明，较大的瘘管直径和CCF的存在是CAF患者发生动脉瘤的独立危险因素。手术成功率（75% vs. 75%，P = 1）、瘘管再通率（11.11% vs. 16.67%，p = 0.42）和再干预率（3.7% vs. 6.25%，p = 0.89）相似结论较大的瘘口直径和冠状动脉前房瘘的存在是CAF患者发生动脉瘤的独立危险因素。对于患有和不患有动脉瘤的 CAF 患者，经导管封堵的结果相当，尽管动脉瘤患者中瘘管封堵后血栓形成似乎更常见。