Collagen embolization for the successful treatment of a distal coronary artery perforation

Abstract

A 42-year old man suffered a coronary artery perforation in the right coronary artery secondary to a hydrophilic guidewire. We describe for the first time the use of collagen embolization to successfully treat this complication.

Wire Induced Coronary Perforation Finally Terminating into Contained Myocardial Rupture – A Case Report

“…Attempts to closure of the bleeding vessel can be made using prolonged balloon inflation alone or embolization of microcoils, thrombus, fat particles, or intra arterial glue as described by earlier [1][2][3][4][5][6][7][8][9].…”

“…These are also the commonest cause for an overlooked perforation during the procedure, the leak being slow, and patient presenting with pericardial effusion and tamponade only in the post procedure period once he/she is shifted to the ward. Nearly half of these are self terminating with medical management and the other half require a closure of the leaking twig using micro coils, thrombus, fat particles, glue or otherwise [1][2][3][4][5][6][7][8][9]. Interventional management is usually successful except in rare cases.…”

Coronary Perforation Complicating Percutaneous Coronary Intervention – A Case Illustration and Review

“…This should be considered when the perforation is too distal or in a small vessel where stent implant or surgery is not possible. [ 33 , 34 , 35 ]…”

Coronary Artery Perforation

“…57,58 f. Miscellaneous: Other materials that have been used for embolization include synthetic glues, two-component adhesives made of fibrinogen and thrombin, collagen, polyvinyl alcohol particles, and protamine. 54,55,59 Experience of the operator and availability of the embolic materials are the limitations in their usage for distal perforations.…”