The left internal mammary artery to pulmonary vasculature fistula causing significant ischemia: which type of therapy is the best?

Recurrence of symptoms after CABG surgery might be caused by formation of fistulous connections between LIMA and pulmonary vasculature. Percutenous route via coil embolization of these connections has been chosen for the initial treatment modality in majority of cases. However, percutenous coronary intervention of native vessel can be considered as an alternative therapy.