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Guidewire‐Induced coronary perforation successfully treated with subcutaneous fat embolisation: A simple technique available to all
Author(s) -
George Sudhakar,
Cotton James,
Wrigley Ben
Publication year - 2015
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.26003
Subject(s) - medicine , perforation , surgery , embolization , catheter , percutaneous coronary intervention , balloon , myocardial infarction , radiology , cardiology , materials science , punching , metallurgy
A 62‐year‐old man presented with an anterior ST elevation myocardial infarction and underwent primary percutaneous coronary intervention to an occluded diagonal artery. Following stenting, a type III distal guidewire‐induced coronary perforation of the diagonal branch was recognized with extravasation of contrast into the pericardial space. Prolonged balloon inflations proximal to the site of the perforation were unsuccessful. Subcutaneous fat was therefore harvested from the patients upper thigh under local anesthetic and embolized through an Export catheter into the distal diagonal vessel, resulting in the immediate cessation of leak through the site of perforation. We discuss the technical aspects of this technique as well as alternative methods of distal embolization and the potential complications that must be considered. © 2015 Wiley Periodicals, Inc.