Coronary artery perforation, an unusual complication during percutaneous coronary intervention. Cases report

Coronary artery perforation (CAP) during percutaneous intervention is a rare but serious complication due to the risk of cardiac tamponade. It can be visible immediately (perforation secondary to balloon inflation, stent implantation or the creation of a false channel), but it can also manifest secondarily in hemodynamic deterioration during the course of angioplasty (distal perforation by the angioplasty guidewire). The Ellis classification categorizes the types of perfo-rations, and according to it, it enables the management and resolution of the complication. Type III perforation is associated with the treatment of complex injuries. We report 3 cases in our series that presented coronary perforation, one due to stent expansion during optimization of its im-plantation in the main vessel, and two cases due to distal perforation by the coronary guidewire. The three cases were resolved in the ward using different techniques. One CAP was resolved by embolization with Spongostan, another CAP was controlled by releasing a coil and the third CAP was solved with the implantation of two covered stents. Only one of the patients required peri-cardiocentesis due to cardiac tamponade. It is essential to bear predictive factors for CAP in mind, make early diagnoses and resolve using therapeutic options according to the type of perforation. .