Bailout polytetrafluoroethylene-covered stent implantation for left main bifurcation perforation using the kissing stent technique.

ABSTRACT

Coronary artery perforation during percutaneous coronary intervention is a rare, but potentially lethal complication. Immediate balloon expansion at the perforation site can halt the bleeding. Implantation of a coronary polytetrafluoroethylene (PTFE)-covered stent enables the efficient endovascular repair of a coronary artery perforation. However, if the perforation occurs at a bifurcation, a PTFE-covered stent may jail the side branch. We report a difficult case of blowout coronary perforation (Ellis type III) at a left main coronary artery bifurcation, which was successfully sealed with a PTFE-covered stent without interference with the side branch coronary artery circulation. This new strategy might represent a useful salvage option for some patients with a coronary bifurcation perforation. © 2017 Wiley Periodicals, Inc.