Key result
A novel coiling technique using a thrombogenic coil excluded from the lumen by a drug-eluting stent successfully treated an Ellis grade III coronary artery perforation.
Case Report (n=1)
A novel coiling technique combined with a drug-eluting stent can successfully treat Ellis grade III coronary artery perforations, avoiding the limitations of covered stents.
May offer bailout for Ellis III perforations; leaves open need for prospective validation.
Coronary artery perforation (CAP) during percutaneous coronary intervention is a rare but serious complication. Treatment options of CAP include prolonged balloon inflation, covered stent, and coil embolization. Although most cases of CAP can be treated with prolonged balloon inflation, some cases, especially Ellis grade III CAP require covered stents or coiling. Covered stents may require a large bore guide catheter and have a high rate of restenosis, which can be a limiting factor in patients with severe peripheral arterial disease. Coil embolization is generally used in distal CAP because coiling in the proximal vessels results in a large territory of infarction. We present a case of an Ellis grade III CAP during rotational atherectomy successfully treated with a novel coiling technique whereby the thrombogenic coil extends through the perforation outside of the vessel, and the intraarterial portion of the coil is excluded from the lumen by drug-eluting stent placement over the proximal portion of the coil.
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Ingrassia et al. (2018) conducted a case report in Coronary artery perforation (n=1). Novel coiling technique with drug-eluting stent was evaluated on Successful treatment. A novel coiling technique using a thrombogenic coil excluded from the lumen by a drug-eluting stent successfully treated an Ellis grade III coronary artery perforation.
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