A novel method to bail out coronary perforation: Micro-catheter distal perfusion technique

Area of Science:

• Interventional Cardiology
• Cardiovascular Surgery

Background:

• Coronary perforation is a rare but serious complication of percutaneous coronary intervention (PCI).
• Prolonged balloon inflation is a strategy for hemostasis but can cause ischemia, leading to adverse cardiac events.

Observation:

• A 73-year-old woman experienced severe coronary perforation post-stent implantation and post-dilatation.
• The patient developed symptoms indicative of ischemia during attempted prolonged balloon inflation.

Findings:

• A novel "distal perfusion technique" was employed, infusing the patient's arterial blood via micro-catheter to perfuse the distal coronary artery.
• This allowed for a 20-minute balloon inflation, achieving successful hemostasis without inducing significant ischemia.
• The technique effectively mitigated ischemic complications associated with prolonged balloon inflation.

Implications:

• The distal perfusion technique offers a promising method to manage coronary perforations during PCI.
• This approach can prevent or reduce ischemia, improving patient outcomes and safety during complex interventions.
• Further research may validate this technique as a standard procedure for managing PCI-related coronary perforations.