Successful Percutaneous Intervention of Contained Coronary Artery Rupture: The Role of Intracoronary Imaging.

A 66-year-old male presented with ST-segment-elevation myocardial infarction. Percutaneous coronary intervention (PCI) of the culprit right coronary artery lesion was performed, during which a small wire-related perforation was noted. The perforation was no longer visible post procedure and we opted for conservative management. One month later, coronary angiography before intervention of the left anterior descending and circumflex lesions revealed a focal dilation at the site of the earlier wire perforation. Further imaging with intravascular ultrasound and optical coherence tomography visualized the defect and guided treatment options.