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Recrossing a Covered Stent With Kissing Balloon Inflation for Side-Branch Rescue
Satoshi Watanabe1, Atsunori Okamura1, Tomohiro Yamasaki1
1Cardiovascular Center, Sakurabashi Watanabe Advanced Healthcare Hospital, Osaka, Japan.
Insights
Recrossing a covered stent with a guidewire and performing kissing balloon technique (KBT) can restore side-branch flow after coronary perforation during percutaneous coronary intervention. This approach may be a viable bailout strategy for complex bifurcation lesions.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery perforation is a rare but serious complication of percutaneous coronary intervention (PCI).
- Side-branch compromise after covered stent implantation presents a significant challenge in PCI.
- The utility of the kissing balloon technique (KBT) in this scenario is not well-documented.
Background:
Coronary artery perforation is a rare but serious complication of percutaneous coronary intervention. Side-branch compromise after covered stent implantation remains challenging, and the role of the kissing balloon technique (KBT) remains poorly described.
Case Summary:
An 87-year-old woman underwent percutaneous coronary intervention for severe proximal left anterior descending artery stenosis and developed delayed coronary perforation with cardiac tamponade. Emergency pericardial drainage and covered stent implantation were performed, resulting in the occlusion of the left circumflex artery. Recrossing through the covered stent using a high-penetration guidewire enabled KBT, restoring side-branch flow without residual contrast leakage.
Discussion:
Recrossing through a covered stent followed by KBT may represent a feasible bailout strategy for preserving side-branch perfusion in complex bifurcation lesions after coronary perforation.
Take-Home Message:
Recrossing through covered stents followed by KBT may restore side-branch flow and preserve myocardial perfusion.