{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:51:02Z","timestamp":1753890662723,"version":"3.41.2"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background and Objectives:<\/jats:bold> Acquired coronary fistulas (ACFs) are rare coronary artery abnormalities in patients with chronic total occlusion (CTO). It has been found after revascularization, and it may cause fluster during the CTO percutaneous coronary intervention (CTO PCI). How to distinguish between ACFs and coronary perforation (CP) is very important for CTO operators. Chronic total occlusion reopening may reveal the microchannel of the adventitial vascular layers. Some of ACFs have been seen after revascularization. This study aimed to investigate the characteristics of ACFs after successful CTO PCI.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The clinical and procedural characteristics, medical history, and findings in electrocardiography (ECG), echocardiography, and coronary angiography were collected from 2,169 consecutive patients undergoing CTO PCI between January 2018 and December 2019 and analyzed retrospectively.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> About 1,844 (85.02%) underwent successful CTO PCI with complete revascularization. Acquired coronary fistulas were found in 49 patients (2.66%): the majority of patients with ACFs were men (81.63 vs. 60.78%; <jats:italic>p<\/jats:italic> = 0.016) and younger (62.8 vs. 66.69 years; <jats:italic>p<\/jats:italic> = 0.003), and had a history of myocardial infarction (MI) or Q-wave (69.39 vs. 54.21%; <jats:italic>p<\/jats:italic> = 0.035); 38 (77.55%) patients had multiple fistulas (\u22653), and ACFs affected multiple branches of the CTO vessel (\u22653) in 29 (59.18%) patients. None had pericardial effusion, tamponade, and hemodynamic abnormality before or after PCI.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Acquired coronary fistulas after successful CTO PCI are mainly present in young and male patients with a history of MI, and they often involve multiple fistulas and distal CTO vessels.<\/jats:p>","DOI":"10.3389\/fcvm.2021.690890","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T07:51:52Z","timestamp":1640159512000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Characteristics of Acquired Coronary Fistulas After Successful Revascularization of Chronic Total Occlusion"],"prefix":"10.3389","volume":"8","author":[{"given":"Rong","family":"Fan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haipeng","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanan","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wang","family":"Yao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheyong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junbo","family":"Ge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"484","DOI":"10.4330\/wjc.v5.i12.484","article-title":"Coronary-cameral fistulas in adults: acquired types (second of two parts)","volume":"5","author":"Said","year":"2013","journal-title":"World J Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1136\/hrt.39.10.1147","article-title":"Fistula from coronary arteries to left ventricle after myocardial infarction","volume":"39","author":"Ryan","year":"1977","journal-title":"Br Heart J."},{"key":"B3","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.clinimag.2010.08.012","article-title":"Acquired left coronary artery fistula draining to the cardiac vein system after acute myocardial infarction revealed by CT scan","volume":"35","author":"Cassese","year":"2011","journal-title":"Clin Imaging."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S30","DOI":"10.1016\/j.carrev.2017.03.003","article-title":"Coronary artery perforation complicated by recurrent cardiac tamponade: a case illustration and review","volume":"18","author":"DePersis","year":"2017","journal-title":"Cardiovasc Revasc Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2364","DOI":"10.1161\/circulationaha.104.481283","article-title":"Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I","volume":"112","author":"Stone","year":"2005","journal-title":"Circulation."},{"key":"B6","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1161\/CIRCULATIONAHA.119.039797","article-title":"Guiding principles for chronic total occlusion percutaneous coronary intervention","volume":"140","author":"Brilakis","year":"2019","journal-title":"Circulation."},{"key":"B7","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/s0735-1097(85)80380-6","article-title":"Changes in collateral channel filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects","volume":"5","author":"Rentrop","year":"1985","journal-title":"J Am Coll Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"300","DOI":"10.5152\/akd.2011.079","article-title":"Relation between fragmented QRS and collateral circulation in patients with chronic total occlusion without prior myocardial infarction","volume":"11","author":"Kadi","year":"2011","journal-title":"Anadolu Kardiyol Derg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1902","DOI":"10.1016\/j.jcin.2019.05.024","article-title":"A detailed analysis of perforations during chronic total occlusion angioplasty","volume":"12","author":"Hirai","year":"2019","journal-title":"JACC Cardiovasc Interv."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2725","DOI":"10.1161\/01.cir.90.6.2725","article-title":"Increased coronary perforation in the new device era. 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