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Catheter Cardiovasc Interv. 2019 Feb 1;93(2):E98-E100. doi: 10.1002/ccd.27849. Epub 2018 Sep 9.

Novel approach to coronary artery perforation repair.

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Division of Cardiovascular Medicine, Calhoun Cardiovascular Center, University of Connecticut Health Center, University of Connecticut School of Medicine, Farmington, Connecticut.
Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Gangwon, South Korea.


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.


complication; coronary artery perforation; coronary repair; percutaneous coronary intervention


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