title: [Two catheters for one coronary perforation].
abstract: Coronary perforation is a severe complication of percutaneous coronary intervention (PCI) with high mortality and morbidity. The incidence of coronary perforation in patients undergoing PCI ranges from 0.1% to 0.5%. The use of long balloon inflation and reversal anticoagulation is associated with high mortality, periprocedural myocardial infarction and emergency coronary bypass surgery. We present a case of severe coronary perforation treated with the dual catheter technique through the radial and femoral approach. The dual catheter technique enabled rapid delivery of a covered stent without losing control of the perforation site. Our patient did not show pericardial effusion, hemodynamic instability or need for emergency bypass surgery. About 1h after PCI, he developed acute stent thrombosis treated with thromboaspiration and biolimus-eluting stent implantation. At 2 years of follow-up, he was asymptomatic without evidence of exercise-induced ischemia. We conclude that the dual catheter technique is a safe and effective approach to treat PCI-induced severe coronary perforation, and may significantly improve patient outcome compared to historical series.
authors: Lucia
authors: L
authors: Barbieri
authors: Monica
authors: M
authors: Verdoia
authors: Alon
authors: A
authors: Schaffer
authors: Paolo
authors: P
authors: Marino
authors: Giuseppe
authors: G
authors: De Luca
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D005263:Femoral Artery; D006335:Heart Injuries / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D011292:Premedication; D017534:Radial Artery; D015607:Stents; D000077466:Tirofiban; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D014443:Tyrosine; D000077466:Tirofiban; D001241:Aspirin