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Management of coronary artery rupture: covered stent or microcoil embolization
1William Dorros-Isadore Feuer Interventional Cardiovascular Disease Foundation, Ltd., Milwaukee, WI 53215-3660, USA.
Insights
Coronary artery rupture during procedures can be managed without emergency surgery. Novel techniques like autologous vein-covered stents or microcoil embolization offer effective solutions for these critical events.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery rupture is a rare but serious complication during percutaneous coronary interventions.
- Prompt and effective management is crucial to prevent adverse outcomes.
Observation:
- Three distinct cases of coronary artery rupture are presented.
- Ruptures occurred after high-pressure balloon angioplasty, balloon angioplasty of an occluded vessel, and rotational ablation.
- Interventions included Gianturco-Roubin stent placement, balloon angioplasty, and rotational atherectomy.
Findings:
- Successful management of all three coronary artery ruptures was achieved.
- An autologous vein-covered Palmaz stent was used in one case.
- Microcoil embolic vessel occlusion was employed in another case.
- Emergency surgery was avoided in all instances.
Implications:
- Autologous vein-covered stents and microcoil embolization are effective alternative treatments for coronary artery rupture.
- These techniques can help avoid emergent surgical intervention.
- This study provides novel insights into managing complex coronary artery dissections and ruptures.
Abstract:
The management of three cases of coronary artery rupture is described: (1) after high-pressure balloon angioplasty following uneventful placement of three Gianturco-Roubin stents, (2) following balloon angioplasty of an occluded diagonal branch, and (3) subsequent to rotational ablation of a left main and proximal circumflex arteries. Placement of an autologous vein-covered Palmaz stent or microcoil embolic vessel occlusion solved each problem. In each case, emergency surgery was avoided; subsequent management, including anticoagulation (when indicated), was performed without incident. This is the first communication detailing correction of a coronary vessel rupture with an autologous vein-covered stent or by microcoil embolic vessel occlusion.