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Novel approach to coronary artery perforation repair
Author(s) -
Ingrassia Joseph,
Youn Young Jin,
Lee Juyong,
Azrin Michael,
Khalid Salman
Publication year - 2019
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.27849
Subject(s) - medicine , perforation , stent , surgery , lumen (anatomy) , balloon , restenosis , radiology , percutaneous coronary intervention , embolization , percutaneous , myocardial infarction , atherectomy , cardiology , materials science , punching , metallurgy
Coronary artery perforation (CAP) during percutaneous coronary intervention is a rare but serious complication. Treatment options of CAP include prolonged balloon inflation, covered stent, and coil embolization. Although most cases of CAP can be treated with prolonged balloon inflation, some cases, especially Ellis grade III CAP require covered stents or coiling. Covered stents may require a large bore guide catheter and have a high rate of restenosis, which can be a limiting factor in patients with severe peripheral arterial disease. Coil embolization is generally used in distal CAP because coiling in the proximal vessels results in a large territory of infarction. We present a case of an Ellis grade III CAP during rotational atherectomy successfully treated with a novel coiling technique whereby the thrombogenic coil extends through the perforation outside of the vessel, and the intraarterial portion of the coil is excluded from the lumen by drug‐eluting stent placement over the proximal portion of the coil.