Muhammad Syukri, M. Yanni, Masrul Syafri, Shindu Phalguna, Alles Firmansyah, Merlin Sari Mutma Indah, Ivan Mahendra, Hadi Zulkarnain
{"title":"Double set up technique as a bailout of diagonal branch coronary perforation: a case report","authors":"Muhammad Syukri, M. Yanni, Masrul Syafri, Shindu Phalguna, Alles Firmansyah, Merlin Sari Mutma Indah, Ivan Mahendra, Hadi Zulkarnain","doi":"10.13181/mji.cr.247266","DOIUrl":null,"url":null,"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.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Indonesia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.13181/mji.cr.247266","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
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.
期刊介绍:
Medical Journal of Indonesia is a peer-reviewed and open access journal that focuses on promoting medical sciences generated from basic sciences, clinical, and community or public health research to integrate researches in all aspects of human health. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures, treatment, or other health issues that is important for the development of health care system are also acceptable. Letters and commentaries of our published articles are welcome.