title: A novel method to bail out coronary perforation: Micro-catheter distal perfusion technique.
abstract: Coronary perforation is a rare, but life-threatening complication during percutaneous coronary intervention. Prolonged balloon inflation is one option for achieving hemostasis, but it often causes ST elevation, chest pain, decreased blood pressure, or fatal arrhythmia due to ischemia. We present the case of a 73-year-old woman who suffered severe coronary perforation after stent implantation and post-dilatation. To allow prolonged balloon inflation without ischemia, we perfused the distal area with the patient's own arterial blood injected via micro-catheter. With this method, we could prolong balloon inflation for 20 min, successfully achieving hemostasis. This novel technique, which we named the "distal perfusion technique," is useful to minimize ischemia during prolonged balloon inflation.
authors.affiliation: Department of Cardiology, Mimihara General Hospital, Osaka, Japan.
authors.forename: Shozo
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Department of Cardiology, Mimihara General Hospital, Osaka, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Tabata
authors.affiliation: Department of Cardiology, Mimihara General Hospital, Osaka, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000628:therapy*; D003331:Coronary Vessels / Q000293:injuries*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015425:Myocardial Reperfusion / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D015607:Stents / Q000009:adverse effects*; D057772:Vascular System Injuries / Q000628:therapy*
keywords: complication; coronary perforation; hemostasis; percutaneous coronary intervention