TY - JOUR
T1 - Distal Coronary Perforation Sealing With Combined Coil and Fat Embolization
AU - Guddeti, Raviteja R.
AU - Kostantinis, Spyridon T.
AU - Karacsonyi, Judit
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/7
Y1 - 2022/7
N2 - Distal coronary perforation is a rare complication of percutaneous coronary intervention. While temporary balloon occlusion of the proximal coronary artery is the first step in perforation management, more definitive treatment options include covered stent implantation for large vessel perforations or fat/coil embolization for distal vessel perforations. We report a case of an 81-year old man who presented with inferior/posterior ST-segment elevation acute myocardial infarction. Coronary angiography showed a 90% distal left circumflex artery (LCx) stenosis. Percutaneous coronary intervention of the culprit vessel was challenging due to balloon uncrossable lesions in LCx and was complicated by distal coronary perforation due to excessive wire movement. Two Axium coils were delivered using a Finecross microcatheter but failed to seal the perforation. We performed fat embolization (proximal to the coils) that successfully sealed the perforation. In selected cases where coil embolization alone fails to seal a distal coronary perforation, combined coil and fat embolization might help achieve hemostasis.
AB - Distal coronary perforation is a rare complication of percutaneous coronary intervention. While temporary balloon occlusion of the proximal coronary artery is the first step in perforation management, more definitive treatment options include covered stent implantation for large vessel perforations or fat/coil embolization for distal vessel perforations. We report a case of an 81-year old man who presented with inferior/posterior ST-segment elevation acute myocardial infarction. Coronary angiography showed a 90% distal left circumflex artery (LCx) stenosis. Percutaneous coronary intervention of the culprit vessel was challenging due to balloon uncrossable lesions in LCx and was complicated by distal coronary perforation due to excessive wire movement. Two Axium coils were delivered using a Finecross microcatheter but failed to seal the perforation. We performed fat embolization (proximal to the coils) that successfully sealed the perforation. In selected cases where coil embolization alone fails to seal a distal coronary perforation, combined coil and fat embolization might help achieve hemostasis.
KW - Coil embolization
KW - Coronary perforation
KW - Fat embolization
UR - http://www.scopus.com/inward/record.url?scp=85120934091&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120934091&partnerID=8YFLogxK
U2 - 10.1016/j.carrev.2021.12.001
DO - 10.1016/j.carrev.2021.12.001
M3 - Article
C2 - 34903484
AN - SCOPUS:85120934091
SN - 1553-8389
VL - 40
SP - 222
EP - 224
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
ER -