Coronary Artery Perforation and Regrowth of a Side Branch Occluded by a Polytetrafluoroethylene-Covered Stent Implantation

Shams Y-Hassan,Christer Sylvén,Loghman Henareh

doi:10.5402/2011/212851

Abstract

Stenting of the right coronary artery stenosis caused coronary perforation and profound dye (blood) extravasation in a 69-year-old female patient. Instantaneous balloon inflation followed by implantation of a polytetrafluoroethylene- (PTFE-)covered stent sealed the coronary perforation, restored the blood flow, and perceivably caused acute occlusion of a large side branch (SB). The immediate in situ balloon inflation prevented the development of cardiac tamponade. Surprisingly, followup coronary angiography 4 and 11 months later showed spontaneous recanalization of the SB occluded by PTFE-covered stent. The SB was filled through a channel beginning at the end of the covered stent streaming retrogradely beneath it toward the SB ostium. Up to the best of our knowledge, this is the first described case of late spontaneous recanalization of as SB occluded by a PTFE-covered stent.

Highlights

Coronary artery perforation is a rare but life-threatening complication of percutaneous coronary intervention (PCI) [1, 2]
Spontaneous recanalization of an occluded side branch (SB) is common after implantation of both bare-metal and drugeluting stents, but it has not been reported after occlusion by PTFE-covered stent implantation [4]
To the best of our knowledge, for the first time, we report on a patient with spontaneous late recanalization of a SB occluded by a PTFE-covered stent implanted to seal a coronary perforation

Summary

Introduction

Coronary artery perforation is a rare but life-threatening complication of percutaneous coronary intervention (PCI) [1, 2]. Among the measures used to treat coronary perforation is the implantation of polytetrafluoroethylene- (PTFE-) covered stent, which will seal the perforation and perceivably occlude the side branches (SBs) originating from the stented region [3]. Spontaneous recanalization of an occluded SB is common after implantation of both bare-metal and drugeluting stents, but it has not been reported after occlusion by PTFE-covered stent implantation [4]. To the best of our knowledge, for the first time, we report on a patient with spontaneous late recanalization of a SB occluded by a PTFE-covered stent implanted to seal a coronary perforation

Case Presentation

Findings

Discussion