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Left main perforation and acute stent thrombosis—a cath lab nightmare
Author(s) -
Fang HsiuYu,
Wu ChiungJen
Publication year - 2011
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23033
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , intravascular ultrasound , stent , perforation , surgery , thrombosis , complication , extracorporeal membrane oxygenation , radiology , cardiology , myocardial infarction , punching , materials science , metallurgy
Coronary perforation is a rare, but life‐threatening, complication that can develop during a percutaneous coronary intervention (PCI). Prompt nonsurgical treatment such as covered stent deployment can potentially arrest progression of the condition; however, other lethal complications such as acute stent thrombosis or side branch occlusion can occur. This report describes a case of perforation of the left main coronary artery that was successfully managed via stenting; however, acute stent thrombosis and side branch occlusion subsequently occurred under extracorporeal membrane oxygenation support. Means of avoiding this tragic outcome involve the routine use of intravascular ultrasound in patients undergoing PCI of the left main coronary artery, being respectful of circumferential calcification, and keeping the procedure as simple as possible. © 2011 Wiley‐Liss, Inc.