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Covered stent implantation through a single 8‐french guide catheter for the management of a distal coronary perforation
Author(s) -
Sandoval Yader,
Lobo Angie S.,
Brilakis Emmanouil S.
Publication year - 2017
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.27020
Subject(s) - medicine , catheter , tamponade , stent , ostium , perforation , balloon , surgery , covered stent , cardiac tamponade , radiology , balloon catheter , materials science , punching , metallurgy
Distal coronary perforation can cause early or late tamponade and is usually treated with fat or coil embolization. An alternative treatment strategy is occlusion of the ostium of the perforated vessel via implantation of a covered stent in the main vessel, which is typically achieved using the ping‐pong guide catheter technique. In this technique, a balloon is inflated over one guide catheter to stop pericardial bleeding and a covered stent is delivered through a second guide catheter due to inability to fit both a balloon and a covered stent through a single guide catheter. With development of lower profile rapid exchange covered stents, a single guide catheter can be used to both occlude the target vessel and deliver the covered stent. We describe a case of distal vessel perforation in which a balloon was inflated to stop pericardial bleeding, followed by delivery of a covered stent (Graftmaster, Abbott Vascular) through a single 8‐Fr guide catheter. This “block and deliver” technique represents a novel paradigm for treating coronary perforations through a single guide catheter, obviating the need for the ping‐pong guide catheter technique. © 2017 Wiley Periodicals, Inc.