F-54 | When Coils Fail: Autologous Fat Embolization for Distal Coronary Artery Perforation Complicating PCI

Sami Shoura; Kyle Coombes; Ragavendar Saravanabavanandan; Abdul-Rahim Z. Shilbayeh; Shreyas Singireddy; Pablo Barzallo; Samuel Mortoti; John Rashid

doi:10.1016/j.jscai.2026.105166

April 1, 2026Journal of the Society for Cardiovascular Angiography & InterventionsOpen Access

F-54 | When Coils Fail: Autologous Fat Embolization for Distal Coronary Artery Perforation Complicating PCI

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Key Points

Evaluate autologous fat embolization as a minimally invasive, surgical-sparing bailout strategy for distal coronary artery perforation complicating percutaneous coronary intervention after coil embolization failure.
A patient presenting with acute coronary syndrome underwent emergent coronary angiography and percutaneous coronary intervention with aspiration thrombectomy, guidewire exchange, balloon angioplasty, and echocardiographic monitoring.
Following the development of distal coronary artery perforation and hemodynamic compromise, emergent pericardiocentesis, balloon occlusion, and attempted coil embolization were performed.
Autologous fat embolization was executed using harvested, macerated abdominal fat administered in staged microcatheter injections.
Autologous fat embolization successfully sealed the distal coronary perforation following coil embolization failure, achieving angiographic absence of contrast extravasation.
Blood flow in the proximal and mid–second diagonal branch was successfully preserved, and the patient stabilized without recurrent cardiac tamponade or ischemic complications.
Temporary intra-aortic balloon pump support was complicated by acute severe aortic regurgitation, which resolved promptly after device removal.

Structured PICO

P

Population

1 patient undergoing emergent coronary angiography and percutaneous coronary intervention (PCI) who developed distal coronary artery perforation and failed coil embolization.

I

Intervention

Autologous fat embolization using harvested, macerated abdominal fat delivered in staged microcatheter injections.

O

Outcome

Sealing of the perforation and clinical stabilization

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Implication

Autologous fat embolization can serve as an effective surgical-sparing rescue strategy for distal coronary artery perforations complicating PCI when conventional coil embolization fails.

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Cite This Study

Shoura et al. (2026) studied this question.

synapsesocial.com/papers/69edab814a46254e215b3778 https://doi.org/10.1016/j.jscai.2026.105166

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F-54 | When Coils Fail: Autologous Fat Embolization for Distal Coronary Artery Perforation Complicating PCI

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

F-54 | When Coils Fail: Autologous Fat Embolization for Distal Coronary Artery Perforation Complicating PCI

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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