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Compressive Coronary Intramural Hematoma: A Case Report
Achmad F Yahya1, Aninka Saboe2
1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, IDN.
Insights
Percutaneous coronary intervention for chronic total occlusion (CTO-PCI) is challenging. A rare complication, intramural hematoma (IMH), was successfully treated with a cutting balloon, demonstrating effective management of CTO-PCI complications.
Area of Science:
- Interventional Cardiology
- Cardiovascular Research
- Medical Device Technology
Background:
- Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions presents significant challenges in interventional cardiology.
- CTO-PCI procedures are associated with higher complication rates compared to non-CTO interventions due to their inherent complexity.
Observation:
- A case of iatrogenic compressive coronary intramural hematoma (IMH) occurred as a complication during a CTO-PCI procedure.
- The intramural hematoma was detected through careful observation and diagnostic assessment.
Findings:
- The iatrogenic compressive coronary intramural hematoma (IMH) was successfully managed.
- A cutting balloon angioplasty was employed as the therapeutic intervention for the IMH.
Implications:
- This case highlights the importance of recognizing and managing rare complications like IMH during CTO-PCI.
- Successful treatment with a cutting balloon offers a viable strategy for managing such iatrogenic events, potentially improving patient outcomes in complex PCI cases.
Abstract:
Despite the advancement of various devices and techniques, percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesion remains one of the major challenges in interventional cardiology fields. It is also associated with higher complications than non-CTO-PCI due to procedural complexity. We presented a case of iatrogenic compressive coronary intramural hematoma (IMH) as CTO-PCI complications, which was judiciously detected and successfully managed with a cutting balloon.
