Management of Septal Branch Perforation and Septal Hematoma During Retrograde Treatment of Coronary Chronic Total Occlusion Using Fat Embolization

Paola Scarparo; Jeroen Wilschut; Nicolas M Van Mieghem; Roberto Diletti

doi:10.1016/j.cjca.2019.12.012

Management of Septal Branch Perforation and Septal Hematoma During Retrograde Treatment of Coronary Chronic Total Occlusion Using Fat Embolization

Can J Cardiol. 2020 Jun;36(6):966.e15-966.e17. doi: 10.1016/j.cjca.2019.12.012. Epub 2019 Dec 17.

Authors

Paola Scarparo¹, Jeroen Wilschut¹, Nicolas M Van Mieghem¹, Roberto Diletti²

Affiliations

¹ Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
² Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: r.diletti@erasmusmc.nl.

PMID: 32376345
DOI: 10.1016/j.cjca.2019.12.012

Abstract

Septal vessel perforation followed by septal hematoma is a rare complication of retrograde approach for treatment of coronary chronic total occlusions, possibly leading to septal rupture. We report 2 cases of patients with septal vessel perforation and subsequent hematoma successfully treated with autologous fat embolization. Such technique is inexpensive, omnipresent, and relatively easy to perform.

Publication types

Case Reports
Video-Audio Media

MeSH terms

Aged
Angioplasty, Balloon, Coronary / adverse effects*
Angioplasty, Balloon, Coronary / methods
Collateral Circulation
Coronary Angiography / methods
Coronary Circulation
Coronary Occlusion / surgery*
Coronary Vessels / diagnostic imaging
Coronary Vessels / surgery
Embolization, Therapeutic* / adverse effects
Embolization, Therapeutic* / methods
Female
Heart Injuries* / diagnosis
Heart Injuries* / etiology
Heart Injuries* / therapy
Heart Septum* / diagnostic imaging
Heart Septum* / injuries
Heart Septum* / pathology
Hematoma* / diagnostic imaging
Hematoma* / etiology
Hematoma* / therapy
Humans
Intraoperative Complications / etiology
Intraoperative Complications / prevention & control
Male
Middle Aged
Subcutaneous Fat / transplantation
Treatment Outcome