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Updated: Jul 14, 2026

Vascular Balloon Injury and Intraluminal Administration in Rat Carotid Artery
09:41

Vascular Balloon Injury and Intraluminal Administration in Rat Carotid Artery

Published on: December 23, 2014

A bleeding kiss: intramural haematoma secondary to balloon angioplasty

Cheerag Shirodaria1, William J Van Gaal, Adrian P Banning

  • 1Department of Cardiology, John Radcliffe Hospital, Oxford, UK. cshirodaria@doctors.org.uk

Cardiovascular Ultrasound
|June 7, 2007
PubMed

Insights

Intramural coronary hematoma, a rare complication of percutaneous coronary intervention (PCI), can occur without dissection. Kissing balloon inflations require caution in patients on warfarin.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Intramural coronary hematoma is a rare complication following percutaneous coronary intervention (PCI).
  • This phenomenon can occur even in the absence of coronary dissection.
  • Coronary artery complications require careful management and understanding.

Observation:

  • A 69-year-old female with a prosthetic aortic valve underwent PCI of the left mainstem to left anterior descending artery (LAD).
  • Kissing balloon inflations were performed on the LAD and circumflex (Cx) arteries.
  • Initial intravascular ultrasound (IVUS) confirmed widely patent vessels post-procedure.

Findings:

  • The patient developed ischemic chest pain six hours after PCI.
  • Repeat angiography revealed significant stenosis in the proximal Cx vessel.
  • IVUS confirmed the stenosis to be an intramural hematoma.

Implications:

  • Kissing balloon inflations warrant caution in patients receiving warfarin alongside antiplatelet therapy.
  • This case highlights a rare but serious complication of PCI.
  • Further research into managing intramural hematoma post-PCI is needed.
Abstract

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