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Catheter Cardiovasc Interv. 2019 Feb 21. doi: 10.1002/ccd.28114. [Epub ahead of print]

Treatment of rotablation-induced ostial left circumflex perforation by papyrus covered stent and its fenestration to recover the left anterior descending artery during CHIP procedure.

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Heart and Lung Institute, The Prince Charles Hospital, Chermside, Queensland, Australia.
University of Queensland, Chermside, Queensland, Australia.


Coronary artery perforation is a rare complication of percutaneous coronary intervention (PCI). Covered stents have been successfully used in these situations. We report a case of ostial left circumflex (LCx) artery perforation during rotablation PCI of left main coronary artery (LMCA) and LCx artery. After failed attempts to balloon tamponade the perforation, a PK Papyrus covered stent was deployed from proximal LCx into LMCA. This resulted in acute exclusion of the left anterior descending (LAD) artery from coronary circulation. Using a dual lumen catheter, a stiff wire was advanced through the side port toward the occluded LAD to fenestrate the membrane of the covered stent. A series of balloons were used to dilate the fenestration in the covered stent to restore a normal flow into the LAD.


CHIP; coronary perforation; papyrus covered stent; rotablation


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