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New Techniques in Iatrogenic Coronary Artery Perforation Management Including Umbrella Technique, Case Report
Mateusz Sucharski1, Małgorzata Kurpaska1, Michał Malinowski1
1Department of Cardiology and Internal Medicine, Military Institute of Medicine, National Research Institute, ul. Szaserów 128, 04-141 Warsaw, Poland.
Insights
This case report details managing a rare complication of coronary angioplasty: iatrogenic coronary artery perforation. Timely pericardiocentesis and novel techniques like the umbrella technique with thrombin injection successfully treated the life-threatening cardiac tamponade.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Case Reports
Background:
- Iatrogenic coronary artery perforation is a rare but serious complication during percutaneous coronary intervention.
- Life-threatening cardiac tamponade can rapidly develop, necessitating prompt and effective management strategies.
- Standard treatment protocols for such perforations are not always clearly defined, highlighting the need for case-based evidence.
Abstract:
This case report presents a patient with iatrogenic coronary artery perforation during coronary angioplasty, complicated with a life-threatening cardiac tamponade. Tamponade decompression was achieved via timely pericardiocentesis with direct autotransfusion. The coronary artery perforation itself was initially closed by using the umbrella technique, which involves distal vessel occlusion with angioplasty balloon fragments. To control further blood extravasation into the pericardial sac, the perforation site was injected with thrombin, ensuring the leak closure. If performed with caution, these relatively rarely used, management techniques are effective in dealing with percutaneous coronary intervention complications.
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