Complications

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A 62-year-old man presented with an anterior ST elevation myocardial infarction and underwent primary percutaneous coronary intervention to an occluded diagonal artery. Following stenting, a type III distal guidewire-induced coronary perforation of the diagonal branch was recognized with extravasation of contrast into the pericardial space. Prolonged balloon inflations proximal to the site of the perforation were unsuccessful. Subcutaneous fat was therefore harvested from the patients upper thigh under local anesthetic and embolized through an Export catheter into the distal diagonal vessel, resulting in the immediate cessation of leak through the site of perforation...

Deployment of polytetrafluoroethylene (PTFE)-covered stent is a useful technique to seal coronary perforation. However, the high profile and low flexibility compromise its deliverability. To facilitate stent delivery, a guide extension catheter (GuideLiner™ catheter) through a 6 Fr guiding catheter has been used. This case report describes a successful deployment of a PTFE-covered stent using a 6 Fr GuideLiner catheter to seal coronary perforation.