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

Introduction Coronary 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 methods We report on effective management of Ellis type III CAP with use of double-guiding catheter technique and stent-graft implantation. Results Prolonged 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. Conclusions The procedure minimises the time between deflation of the balloon and implantation of the stent-graft, allowing for successful bleeding cessation.

Abstract licence: CC BY-NC-SA

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