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

Ewa Ostrowska; Aleksandra Gąsecka; Tomasz Mazurek; Janusz Kochman

doi:10.5114/aoms/143151

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

Arch Med Sci. 2021 Oct 29;17(6):1800-1803. doi: 10.5114/aoms/143151. eCollection 2021.

Authors

Ewa Ostrowska¹, Aleksandra Gąsecka¹, Tomasz Mazurek¹, Janusz Kochman¹

Affiliation

¹ 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Abstract

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.

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.

Keywords: coronary perforation; double-guiding catheter technique; stent-graft.