scholarly journals Successful Management of Coronary Artery Rupture with Stent-Graft: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Berkay Ekici ◽  
Aycan Fahri Erkan ◽  
Utku Kütük ◽  
Hasan Fehmi Töre
Keyword(s):  
Coronary Artery ◽  
Stent Graft ◽  
Distal Portion ◽  
Metal Stents ◽  
Stent Grafts ◽  
Successful Management ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
Life Threatening ◽  
Coronary Artery Rupture

Perforation of coronary arteries is a relatively rare yet life-threatening complication of percutaneus coronary interventions and is encountered in approximately 0.5% of these procedures. According to the type of coronary perforation, various methods of correction are employed, ranging from conservative approach to emergency cardiac surgery. Coronary stent-grafts are composed of two metal stents and a polytetrafluoroethylene layer between them. Advent of such stents enabled efficient endovascular repair of coronary artery perforation. We present a case of coronary artery perforation which had occurred during stent implantation for the treatment of a bridged segment in the distal portion of the left anterior descending artery. This perforation was successfully managed by implanting a stent-graft.

scholarly journals Coronary Perforation- A Nightmare in Cath Lab

2021 ◽  
Author(s):  
Ashok Kumar Thakur ◽  
Puneet Aggarwal ◽  
Rajeev Bharadwaj ◽  
Bhagya Narayan Pandit ◽  
Ranjit Kumar Nath
Keyword(s):  
Coronary Artery ◽  
Standard Of Care ◽  
Coronary Intervention ◽  
Modern Technology ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Incidence Risk ◽  
Life Threatening ◽  
Artery Disease

Percutaneous Coronary Intervention (PCI) is now the standard of care in patients with coronary artery disease. With advances in modern technology, the success of PCI has relatively increased, and so is its complication, specifically in complex coronary intervention. Coronary perforation is one of the most dreadful and life-threatening complications of PCI. The most vital step in the management of coronary perforation is its identification and quick action. Multiple methods for management are now recommended in the literature, but the mainstay of treatment is still prevention. This review discusses the incidence, risk factors, prevention, identification, and management of Coronary Artery Perforation (CAP).

scholarly journals Looped wire advancement—not always safe! Fat—not so useless! a case series

2021 ◽  
Vol 5 (11) ◽  
Author(s):  
Atit A Gawalkar ◽  
Navreet Singh ◽  
Ankush Gupta ◽  
Parag Barwad
Keyword(s):  
Coronary Artery ◽  
False Lumen ◽  
Case Series ◽  
Coronary Intervention ◽  
Elastic Recoil ◽  
Autologous Fat ◽  
Coronary Artery Perforation ◽  
Vessel Injury ◽  
Coronary Perforation ◽  
Life Threatening

Abstract Background Coronary artery perforation (CAP), although rare, can often be a life-threatening complication of percutaneous coronary intervention. Looped wire tip or buckling of wire is conventionally considered safer due to reduced risk of migration into smaller branches and false lumen. Occasionally, buckling can indicate the entry of tip into dissection plane, or the advancement of looped wire can cause small vessel injury leading to perforation. Distal coronary perforation can be life threatening and coil, foam, and thrombin injection are some of the material widely used for sealing it. Case summary We hereby report three different cases illustrating the vessel injury that the looped wire can cause in the distal vasculature related to various mechanisms like high elastic recoil tension, dissection by the non-leading wire tip, or hard wire lacerating the fragile small branches. All these mechanisms lead to distal coronary perforation leading to cardiac tamponade. Each case also illustrate the novel technique of autologous fat globule embolization for the management of distal CAP. Discussion Distal coronary perforation is often due to guidewire-related vessel injury and is more common with hydrophilic wires. Looped wire tip can sometime indicate vessel injury and its advancement further down the coronary artery may result in serious vessel injury and perforation. Management of distal coronary perforation is challenging, and here we demonstrate the steps of using the readily available autologous fat globules by selectively injecting them into the small coronary artery to control the leak.

scholarly journals Stent-graft and double-guiding catheter technique to rescue iatrogenic coronary perforation

2021 ◽  
Vol 17 (6) ◽  
pp. 1800-1803
Author(s):  
Ewa Ostrowska ◽  
Aleksandra Gąsecka ◽  
Tomasz Mazurek ◽  
Janusz Kochman
Keyword(s):  
Stent Graft ◽  
Coronary Artery Perforation ◽  
Catheter Technique ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
Temporary Closure ◽  
Stent Graft Implantation ◽  
Graft Implantation ◽  
Guiding Catheter

IntroductionCoronary artery perforation (CAP) is an infrequent, yet life-threatening complication of percutaneous coronary interventions, posing a major risk of cardiac tamponade and mortality.Material and methodsWe report on effective management of Ellis type III CAP with use of double-guiding catheter technique and stent-graft implantation.ResultsProlonged balloon inflation via the first guiding catheter allows for temporary closure of the bleeding site. At the same time, stent-graft is inserted via the second guiding catheter to seal the perforation. After rapid deflation of the balloon, the stent is immediately advanced and expanded.ConclusionsThe procedure minimises the time between deflation of the balloon and implantation of the stent-graft, allowing for successful bleeding cessation.

scholarly journals Grade III Coronary Artery Perforation Following PCI and Unusual Stent Graft Delivery System

2014 ◽  
Vol 15 (2) ◽  
pp. 101-103
Author(s):  
Miodrag Sreckovic ◽  
Nikola Jagic ◽  
Vladimir Miloradovic ◽  
Mladen Tasic ◽  
Dusan Nikolic
Keyword(s):  
Coronary Artery ◽  
Stent Graft ◽  
Bare Metal Stent ◽  
Covered Stent ◽  
Severe Form ◽  
Bare Metal ◽  
Metal Stent ◽  
High Profile ◽  
Coronary Artery Perforation ◽  
Grade Iii

ABSTRACT Coronary perforations are rare but vicious complications of PCI procedures. Ellis type III coronary artery perforation represents the most severe form and demands an urgent solution. It is often necessary to perform pericardiocentesis and utilizise multiple interventional techniques to seal the perforation. Polytetrafluoroethylene (PTFE)-covered stent implantation has become one of the most frequently used percutaneous solutions, but disadvantages of this intervention are its high profile and low device flexibility. In our case, we attempted to improve the deliverability of the PTFE stent graft alone by mounting it on a bare metal stent used as a stent graft carrier.

scholarly journals Balloon Occlusion Types in the Treatment of Coronary Perforation during Percutaneous Coronary Intervention

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Xiangfei Wang ◽  
Junbo Ge
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Anticoagulant Activity ◽  
Coronary Intervention ◽  
Pericardial Tamponade ◽  
Balloon Occlusion ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Pros And Cons

Coronary artery perforation is an uncommon complication in patients with coronary heart disease undergoing percutaneous coronary intervention. However, pericardial tamponade following coronary artery perforation may be lethal, and prompt treatment is crucial in managing such patients. Balloon occlusion and the reversal of anticoagulant activity are the common methods used to prevent cardiac tamponade by reducing the amount of bleeding. Herein, we discuss the pros and cons of currently used occlusion types for coronary perforation. Optimal balloon occlusion methods should reduce the amount of bleeding and ameliorate subsequent myocardial ischemia injury, even during cardiac surgery.

Successful management of coronary artery perforation with helical platinum microcoil embolization

2000 ◽  
Vol 51 (3) ◽  
pp. 320-322 ◽  
Author(s):  
Mohammad Shakil Aslam ◽  
Richard N. Messersmith ◽  
Jonathan Gilbert ◽  
Jeffrey B. Lakier
Keyword(s):  
Coronary Artery ◽  
Successful Management ◽  
Coronary Artery Perforation

scholarly journals Coronary Artery Perforation and Regrowth of a Side Branch Occluded by a Polytetrafluoroethylene-Covered Stent Implantation

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Shams Y-Hassan ◽  
Christer Sylvén ◽  
Loghman Henareh
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Coronary Artery Stenosis ◽  
Covered Stent ◽  
Side Branch ◽  
Balloon Inflation ◽  
Coronary Artery Perforation ◽  
Coronary Perforation ◽  
The Right

Stenting of the right coronary artery stenosis caused coronary perforation and profound dye (blood) extravasation in a 69-year-old female patient. Instantaneous balloon inflation followed by implantation of a polytetrafluoroethylene- (PTFE-)covered stent sealed the coronary perforation, restored the blood flow, and perceivably caused acute occlusion of a large side branch (SB). The immediate in situ balloon inflation prevented the development of cardiac tamponade. Surprisingly, followup coronary angiography 4 and 11 months later showed spontaneous recanalization of the SB occluded by PTFE-covered stent. The SB was filled through a channel beginning at the end of the covered stent streaming retrogradely beneath it toward the SB ostium. Up to the best of our knowledge, this is the first described case of late spontaneous recanalization of as SB occluded by a PTFE-covered stent.

scholarly journals Giant Intramural Right Ventricular Hematoma after PCI in a Patient with Condition after CABG

2020 ◽  
Vol 09 (01) ◽  
pp. e11-e14
Author(s):  
Maximilian Vondran ◽  
Tamer Ghazy ◽  
Terezia Bogdana Andrási ◽  
Jürgen Graff ◽  
Ardawan Julian Rastan
Keyword(s):  
Coronary Artery ◽  
Right Ventricular ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Intramural Hematoma ◽  
Coronary Intervention ◽  
Heart Team ◽  
Coronary Artery Perforation ◽  
Life Threatening ◽  
The Right

AbstractCoronary artery perforation secondary to percutaneous coronary intervention (PCI) is a rare, but a potentially life-threatening complication. There is a misconception that cardiac tamponade rarely occurs in patients with prior coronary artery bypass grafting (CABG). We first describe a giant right ventricular intramural hematoma following PCI via a saphenous vein graft to treat a distal stenosis of the right coronary artery, and its successful treatment with redo cardiac surgery. Complex elective PCIs on patients after CABG should be performed in specialized centers with a well-established heart team that has the expertise to treat any of the potential complications.

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