Embolization of a septal branch perforation using subcutaneous fat during a percutaneous coronary intervention of chronic total occlusion by retrograde approach
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Published on: February 18, 2020
Mohsen Mohandes1, Sergio Rojas1, Jordi Guarinos1
1Interventional Cardiology Unit, Cardiology Division, Joan XXIII University Hospital, Tarragona, Spain.
Insights
A rare complication during coronary intervention, septal branch perforation, was successfully treated using autologous fat injection. This innovative technique, combined with balloon inflation, effectively sealed the perforation, offering a new approach for managing such events.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) carries risks.
- Septal artery injury is a rare but serious complication during PCI of the right coronary artery.
Purpose of the Study:
- To report a novel treatment strategy for septal branch perforation during PCI.
- To demonstrate the efficacy of autologous fat grafting in managing coronary artery perforation.
Main Methods:
- A case of right coronary artery CTO PCI complicated by septal branch perforation.
- Treatment involved direct injection of autologous fat into the perforated septal branch.
- Prolonged balloon inflation at the origin of the septal branch was employed to seal the perforation.
Main Results:
- Autologous fat administration led to a significant reduction in extravasation.
- Prolonged balloon inflation definitively sealed the septal branch perforation.
- The patient tolerated the procedure without further complications.
Conclusions:
- Autologous fat grafting is a viable and effective treatment for septal branch perforation during PCI.
- This technique offers a minimally invasive option for managing coronary artery perforations.
- Further research is warranted to evaluate the long-term outcomes of this approach.
Abstract:
We describe a case of septal branch perforation during percutaneous coronary intervention of a right coronary artery chronic total occlusion. The septal branch perforation was treated with administration of autologous fat into the septal branch with significant reduction of extravasation. This treatment was followed by prolonged balloon inflation at the exit point of the septal branch in the donor artery which definitively sealed the perforation.
