Key result
Retrograde and antegrade coil embolization successfully managed a life-threatening coronary perforation with tamponade during a retrograde chronic total occlusion percutaneous coronary intervention.
Case Report (n=1)
Coil embolization can be a successful strategy for managing complex retrograde and antegrade coronary perforations with tamponade during CTO PCI, potentially avoiding the need for emergency cardiac surgery.
Epicardial retrograde CTO PCI carries perforation risk; case report leaves optimal channel selection open.
In recent years, retrograde approach for chronic total occlusions has rapidly evolved, enabling a higher rate of revascularization success. Compared to septal channels, epicardial collaterals tend to be more tortuous, more difficult to negotiate, and more prone to rupture. Coronary perforation is a rare but potentially life-threatening complication of coronary angioplasty, often leading to emergency cardiac surgery. We report a case of a retrograde chronic total occlusion revascularization through epicardial collaterals, complicated by both retrograde and antegrade coronary perforation with tamponade, and successfully managed by coil embolization.
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Boukhris et al. (2015) conducted a case report in Coronary perforation with tamponade during chronic total occlusion percutaneous coronary intervention (n=1). Retrograde and antegrade coil embolization was evaluated on Successful management of coronary perforation and tamponade. Retrograde and antegrade coil embolization successfully managed a life-threatening coronary perforation with tamponade during a retrograde chronic total occlusion percutaneous coronary intervention.
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