Catastrophic Left Main Coronary Artery Perforation During Complex Percutaneous Coronary Intervention: Successful Multidisciplinary Management.

ABSTRACT:

Background

Intravascular ultrasound (IVUS)-related coronary perforations are rare but life-threatening complications of percutaneous coronary interventions.

Case summary

An older woman underwent percutaneous coronary intervention for a severely calcified stenosis in the proximal left anterior descending artery. During IVUS advancement after rotational atherectomy, a longitudinal coronary perforation occurred, resulting in cardiac arrest. Rapid deployment of venoarterial extracorporeal membrane oxygenation (ECMO) was initiated, followed by multiple covered stents and emergency coronary artery bypass grafting.

Discussion

Although balloon hemostasis and pericardiocentesis had not yet been performed, no signs of tamponade on fluoroscopy made us decide on the initial ECMO

SUBMITTER: Sumitsuji S 

PROVIDER: S-EPMC12011146 | biostudies-literature | 2025 Mar

REPOSITORIES: biostudies-literature