Key result
The umbrella technique combined with thrombin injection and pericardiocentesis with autotransfusion successfully managed iatrogenic coronary artery perforation and cardiac tamponade.
Case Report (n=1)
The umbrella technique combined with thrombin injection can be an effective management strategy for iatrogenic coronary artery perforation during percutaneous coronary intervention.
Hypothesis-generating for iatrogenic perforation bailout; should not change practice without prospective data.
This case report presents a patient with iatrogenic coronary artery perforation during coronary angioplasty, complicated with a life-threatening cardiac tamponade. Tamponade decompression was achieved via timely pericardiocentesis with direct autotransfusion. The coronary artery perforation itself was initially closed by using the umbrella technique, which involves distal vessel occlusion with angioplasty balloon fragments. To control further blood extravasation into the pericardial sac, the perforation site was injected with thrombin, ensuring the leak closure. If performed with caution, these relatively rarely used, management techniques are effective in dealing with percutaneous coronary intervention complications.
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Sucharski et al. (2023) conducted a case report in Iatrogenic coronary artery perforation with cardiac tamponade (n=1). Umbrella technique and thrombin injection was evaluated on Closure of perforation and management of tamponade. The umbrella technique combined with thrombin injection and pericardiocentesis with autotransfusion successfully managed iatrogenic coronary artery perforation and cardiac tamponade.
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