Coronary artery perforation successfully treated with a second drug-eluting stent

A coronary artery perforation is a rare, but potentially lethal, complication of percutaneous coronary intervention. We present a case of massive main vessel coronary perforation of the right coronary artery in a patient with acute ST segment elevation myocardial infarction, which was successfully treated with a second drug-eluting stent. This uncommon therapeutic approach was used to preserve flow to the large side branch. Early recognition, rapid balloon re-inflation at the perforation site and a ping-pong guiding technique allowed us to prepare the optimal strategy and to treat the perforation without developing cardiac tamponade.

Automated summary

Coronary artery perforation is a rare but potentially fatal complication of percutaneous coronary intervention. We report a case of massive main vessel coronary perforation in a patient with acute ST segment elevation myocardial infarction, which was successfully treated with a second drug-eluting stent. This unusual therapeutic approach was used to maintain blood flow to the large side branch.