Key result
Microcoil embolization for guidewire-induced coronary perforation unexpectedly reveals vessel patency at 1-year follow-up.
Why the study?
Coronary artery perforation after PCI is a rare but serious complication with various treatment options including coil embolization, yet the permanence of metallic microcoil embolization is uncertain.
Does microcoil embolization provide permanent occlusion in patients with distal guidewire-induced coronary artery perforation?
Case Report (n=1)
No
Does microcoil embolization provide permanent occlusion in patients with distal guidewire-induced coronary artery perforation?
Microcoil embolization for coronary artery perforation may not result in permanent occlusion, as demonstrated by restored patency at 1-year follow-up in this case.
Microcoil embolization may not ensure permanent occlusion in distal perforations; this case leaves open questions on long-term durability.
Coronary artery perforation (CAP) after percutaneous coronary intervention is a rare, but serious complication. It can cause cardiac tamponade, acute myocardial infarction or death. The treatments of CAP involve prolonged balloon inflation, emergent surgery, coil embolization, and implantation of covered stent. We have successfully performed the emergent microcoil embolization in a patient with uncontrolled Ellis grade 3 guidewire-induced CAP resulting in delayed cardiac tamponade. Contrasting our usual expectation, the 1-year follow-up angiography showed a patent flow at the embolized site.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2011) conducted a case report in Coronary artery perforation (CAP) after percutaneous coronary intervention (n=1). Microcoil embolization was evaluated on Patency of the embolized artery at follow-up. Microcoil embolization for an Ellis grade 3 guidewire-induced coronary artery perforation unexpectedly resulted in patent blood flow at the embolized site on 1-year follow-up angiography.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: