Double set up technique as a bailout of diagonal branch coronary perforation: a case report

  • Muhammad Syukri Department of Cardiology and Vascular Medicine, Dr. M. Djamil Hospital, Padang, Indonesia
  • Mefri Yanni Department of Cardiology and Vascular Medicine, Dr. M. Djamil Hospital, Padang, Indonesia
  • Masrul Syafri Department of Cardiology and Vascular Medicine, Dr. M. Djamil Hospital, Padang, Indonesia
  • Shindu Phalguna Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Alles Firmansyah Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Merlin Sari Mutma Indah Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
  • Ivan Mahendra Department of Cardiology and Vascular Medicine, M. Hatta Brain Hospital, Bukittinggi, Indonesia
  • Hadi Zulkarnain Department of Cardiology and Vascular Medicine, Gatot Soebroto Central Army Hospital, Jakarta, Indonesia
DOI: https://doi.org/10.13181/mji.cr.247266
Keywords: complication, coronary artery, stent
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Abstract

Coronary artery perforation is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). A 55-year-old male with a history of implanted stent on the left main ostium to the proximal left circumflex artery (LCX) and distal right coronary artery, and chronic total occlusion (CTO) on ostium left anterior descending (LAD). PCI was performed using a stiff wire to cross the CTO body in LAD. We performed an injection and confirmed the presence of extravasation. We successfully managed to stop the bleeding by placing the tips of floppy wire that were cut into pieces. A drainage pathway was made through thoracotomy for pericardial effusion. Angiography showed persisting extravasation at the wire insertion site. We then made our own covered stent. We implanted on the osteal LAD until proximal LCX. Repeated angiography showed no contrast extravasated from the perforation site, and the patient was stabilized and discharged.

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Published
2024-05-08
How to Cite
1.
Syukri M, Yanni M, Syafri M, Phalguna S, Firmansyah A, Indah MSM, Mahendra I, Zulkarnain H. Double set up technique as a bailout of diagonal branch coronary perforation: a case report. Med J Indones [Internet]. 2024May8 [cited 2024Jul.3];33(1):55-0. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/7266
Issue
Vol. 33 No. 1 (2024): March
Section
Case Report/Series

Copyright (c) 2024 Muhammad Syukri, Mefri Yanni, Masrul Syafri, Shindu Phalguna, Alles Firmansyah, Merlin Sari Mutma Indah, Ivan Mahendra, Hadi Zulkarnain

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