Key result
Covered stenting with pericardiocentesis and autologous transfusion resolves Ellis type III coronary perforation and shock post-PCI.
Why the study?
Coronary artery perforation is a rare but catastrophic complication of PCI, with grade III perforation requiring urgent management strategies.
Case Report (n=1)
Covered stents combined with pericardiocentesis can successfully manage catastrophic Ellis type III coronary perforations following PCI.
Case success with covered stents in Ellis III perforation is hypothesis-generating; leaves open need for prospective data before practice change.
Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention (PCI). Grade III coronary perforation and rupture invariably results in pericardial effusion and tamponade requiring urgent pericardiocentesis. Advances in coronary intervention have increased the opportunity to treat coronary artery perforation. We are reporting a case of 55 years old hypertensive female who presented with effort angina. Coronary angiogram revealed significant stenosis in the left anterior descending coronary artery. Post PCI, she had Ellis type III coronary perforation and pericardial tamponade and cardiogenic shock. The patient was resuscitated, pericardiocentesis done, autologous blood transfusion given and covered stent deployed.
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Srinivas et al. (2014) conducted a case report in Ellis type III coronary perforation following PCI (n=1). Covered stent deployment, pericardiocentesis, and autologous blood transfusion was evaluated on Resolution of complication. Deployment of a covered stent, along with pericardiocentesis and autologous blood transfusion, successfully resolved an Ellis type III coronary perforation and cardiogenic shock following PCI.
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