Successful Management of a Distal Left Main Perforation Using the Jailed-balloon Technique and Covered Stent Fenestration

Covered stents are often used to manage coronary perforations, but they can inadvertently obstruct side branches. Perforations in the left main artery can lead to severe haemodynamic instability, especially if the side branch, the left circumflex artery, becomes completely occluded by the covered stent. The authors describe a successful case of sealing a distal left main perforation using fenestration of a covered stent in combination with a jailed-balloon technique to preserve blood flow to the left circumflex artery.