Novel economic treatment for coronary wire perforation:A case report  

作　　者：Ahmed Abdalwahab Conor McQuillan Mohamed Farag Mohaned Egred 

机构地区：[1]Department of Cardiothoracic,Freeman Hospital,Newcastle upon Tyne NE77DN,United Kingdom [2]Freeman Hospital&Department of Cardiovascular Medicine,Tanta University,Tanta 31512,Egypt [3]Freeman Hospital&Department of Cardiology,Royal Victoria Hospital,Belfast BT126BA,Northern Ireland,United Kingdom [4]Freeman Hospital&School of Life and Medical Sciences,University of Hertfordshire,Hertfordshire AL109EU,United Kingdom [5]Freeman Hospital&Translational and Clinical Research Institute,Newcastle University,Newcastle upon Tyne NE77DN,United Kingdom

出　　处：《World Journal of Cardiology》2021年第6期177-182,共6页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Coronary artery perforation is a rare but potentially life-threatening complication of percutaneous coronary intervention(PCI),however if recognized and managed promptly,its adverse consequences can be minimized.Risk factors include the use of advanced PCI technique(such as atherectomy and chronic total occlusion interventions)and treatment of severely calcified lesions.Large vessel perforation is usually treated with implantation of a covered stent,whereas distal and collateral vessel perforations are usually treated with embolization of coils,fat,thrombin,or collagen.We describe a novel and cost-effective method of embolisation using a cut remnant of a used angioplasty balloon that was successful in sealing a distal wire perforation.we advocate this method as a simple method of managing distal vessel perforation.CASE SUMMARY A 73-year-old male with previous coronary Bypass graft operation and recurrent angina on minimal exertion had undergone rotablation and PCI to his dominant left circumflex.At the end of the procedure there was evidence of wire perforation at the distal branch and despite prolonged balloon tamponade there continued to be extravasation and the decision was made to seal this perforation.A cut piece of an angioplasty balloon was used and delivered on the original angioplasty wire to before the perforation area and released which resulted in sealing of the perforation with no unwanted clinical consequences.CONCLUSION The use of a balloon remnant for embolization in coronary perforation presents a simple,efficient and cost-effective method for managing coronary perforations and may be an alternative for achieving hemostasis and preventing poor outcome.Prevention remains the most important part with meticulous attention to the distal wire position,particularly with hydrophilic wires.

关 键 词：Percutaneous coronary intervention Coronary perforation Coronary guide wire COLLAGEN Coronary angioplasty balloon COIL Case report 

分 类 号：R543.3[医药卫生—心血管疾病]