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[Cardiac perforation complicated by cardiac tamponade and sealed with metallic coils]

Vicens Martí1, Carlos Castaño, Pere Guiteras

  • 1Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 18461vmc@comb.es

Revista Espanola De Cardiologia
|October 8, 2004
PubMed

Insights

Distal coronary artery perforation during angioplasty is rare but serious. This case shows successful coil embolization to manage perforation and cardiac tamponade in a patient on abciximab.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine

Background:

  • Distal coronary artery perforation is a rare but life-threatening complication during percutaneous coronary intervention.
  • Platelet glycoprotein IIb/IIIa receptor inhibitors, such as abciximab, can increase bleeding risk and complicate management.

Observation:

  • A patient on abciximab developed distal right coronary artery perforation due to a guidewire tip.
  • This complication led to acute cardiac tamponade with significant blood extravasation.

Findings:

  • The coronary perforation was successfully treated by deploying two metallic coils into the distal vessel.
  • This endovascular approach effectively controlled the bleeding and tamponade.

Implications:

  • Coil embolization offers a minimally invasive alternative for managing coronary artery perforation and associated cardiac tamponade.
  • This technique can potentially avoid the need for emergent cardiac surgery in select cases.

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