Key result
Proximal prolonged balloon inflation achieves hemostasis in Ellis type III perforation after in situ failure.
Why the study?
There is no standard recommendation on the preferable balloon inflation site for prolonged balloon inflation to treat coronary perforation after PCI.
Case Report (n=1)
Proximal balloon inflation may achieve hemostasis after failed in situ attempts in coronary perforation; leaves open need for prospective validation before practice change.
Coronary perforation (CP) is a rare complication of percutaneous coronary intervention (PCI) and can lead to pericardial tamponade. Prolonged balloon inflation is a reasonable treatment for CP, but there is no standard recommendation on the preferable choice between the balloon site for prolonged balloon inflation (ie, proximal and in situ of the perforation). We present a rare case of successful prolonged balloon inflation at the proximal site of the CP after the failure of balloon inflation at the site of perforation. The patient developed CP during balloon inflation post-stent, rapidly progressing to cardiac tamponade. In situ prolonged balloon inflation (3 times) failed to close the CP, but proximal inflation could manage the CP. The take-home message from this case is that balloon expansion at the proximal site could be better than in situ of perforation in patients with CP after PCI.
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Zheng et al. (2023) conducted a case report in Coronary perforation during percutaneous coronary intervention (n=1). Prolonged balloon inflation at the proximal site vs. Prolonged balloon inflation in situ was evaluated on Hemostasis of coronary perforation. Prolonged balloon inflation at the proximal site successfully achieved hemostasis in a patient with an Ellis type III coronary perforation after in situ balloon inflation failed.
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