Management of Coronary Artery Perforation

Cardiovasc Revasc Med. 2021 May;26:55-60. doi: 10.1016/j.carrev.2020.11.013. Epub 2020 Nov 12.

Abstract

Coronary artery perforation (CAP) is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI), however if recognized and managed promptly, its adverse consequences can be minimized. Risk factors for CAP include the use of advanced PCI technique (such as atherectomy and chronic total occlusion interventions) and treatment of severely calcified lesions. There are 3 major types of CAP depending on location: (a) large vessel perforation, (b) distal vessel perforation, and (c) collateral perforation. Large vessel perforation is usually treated with implantation of a covered stent, whereas distal and collateral vessel perforations are usually treated with coil or fat embolization. In this article we provide a state-of-the-art overview of the contemporary management of CAP.

Keywords: Anticoagulation; Calcification; Coils; Coronary artery perforation; Covered stents; Percutaneous coronary intervention; Pericardial tamponade.

Publication types

  • Review

MeSH terms

  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / surgery
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery
  • Heart Injuries* / diagnostic imaging
  • Heart Injuries* / etiology
  • Heart Injuries* / surgery
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Stents
  • Treatment Outcome