title: Conservative Management of an Epicardial Collateral Perforation During Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention.
abstract: Coronary artery perforation is a highly feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can lead to pericardial effusion, tamponade, and, rarely, emergent cardiac surgery. Perforation of epicardial collaterals during retrograde CTO-PCI may be particularly challenging to treat, as embolization from both sides of the perforation may be required to control the bleeding. However, conservative measures can occasionally be effective. We present a case of epicardial collateral vessel perforation that was managed conservatively with anticoagulation reversal.
authors.forename: Christian
authors.initials: C
authors.lastname: Ngo
authors.forename: George
authors.initials: G
authors.lastname: Christopoulos
authors.affiliation: VA North Texas Health Care System, The University of Texas Southwestern Medical Center at Dallas, Division of Cardiology (111A), 4500 S. Lancaster Rd, Dallas, TX 75216 USA. esbrilakis@gmail.com.
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003097:Collateral Circulation; D000072700:Conservative Treatment / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D054059:Coronary Occlusion / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000293:injuries; D004452:Echocardiography / Q000379:methods; D006494:Heparin Antagonists / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods; D011479:Protamines / Q000008:administration & dosage*; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology
chemical_list: D006494:Heparin Antagonists; D011479:Protamines