Tassanawiwat W, Biondi-Zoccai GGL, Sangiorgi G, Iakovou I, Tsagalou E, Melzi G, Ge L, Morici N, Corvaja N, Colombo A. Percutaneous safenectomy: A potentially dreadful complication of cutting balloon angioplasty in safenous vein grafts.
Int J Cardiol 2006;
106:418-9. [PMID:
16337059 DOI:
10.1016/j.ijcard.2005.01.017]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Accepted: 01/01/2005] [Indexed: 02/08/2023]
Abstract
Vessel perforation is an uncommon but potentially life-threatening complication of percutaneous coronary intervention and is often associated with the use of atheroablative devices. While effective management means are currently available, such as PTFE-covered stent, pericardiocentesis, and perfusion balloon, a timely and skillful approach is of paramount importance to solve this dreadful complication. We hereby describe a case of saphenous vein graft (SVG) perforation occurring after cutting balloon angioplasty for in-stent restenosis. Despite the immediate occurrence of cardiac arrest due to massive extravasation of contrast in the mediastinum with pericardial tamponade, deep catheter intubation enabled the deployment of two PTFE-covered stents and subsequent sealing of the leak with repeated inflation of a perfusion balloon, while hemopericardium was drained by pericardiocentesis. This clinical vignette emphasizes the role of optimal backup in order to deploy life-saving devices and successfully manage life-threatening pericardial tamponade due to SVG rupture.
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