Guidewire-induced coronary artery perforation treated with transcatheter injection of polyvinyl alcohol form

Abstract

We describe a first case of successful transcatheter management of guidewire-induced distal coronary artery perforation and impending cardiac tamponade, which developed during percutaneous coronary angioplasty, with transcatheter injection of polyvinyl alcohol form. This method may be an effective alternative in the management of distal coronary artery perforation requiring surgical repair.

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.…”

A unique and unexplained ricochet leak post PCI – Successfully treated with intra-coronary glue

“…Salvage techniques for CAP including prolonged balloon inflation, 12 polytetrafluoroethylene-covered stents13, 14, 15 and transcatheter embolization of micro-coils,16, 17 subcutaneous tissue, 18 thrombin, 19 a sterile synthetic glue, 1 polyvinyl alcohol, 20 or collagen 21, 22…”

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 ]…”