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REVIEW ARTICLE
Year : 2011  |  Volume : 12  |  Issue : 2  |  Page : 63-70

Coronary perforation and covered stents: An update and review


Department of Cardiology, Royal Hospital, Muscat, Sultanate of Oman

Correspondence Address:
Prashanth Panduranga
Department of Cardiology, Royal Hospital, Post Box 1331, Muscat-111
Sultanate of Oman
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1995-705X.86017

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Coronary perforation is a rare complication of percutaneous coronary intervention. We present two different types of coronary intervention, but both ending with coronary perforation. However, these perforations were tackled successfully by covered stents. This article reviews the incidence, causes, presentation, and management of coronary perforation in the present era of aggressive interventional cardiology. Coronary perforations are classified as type I (extraluminal crater), II (myocardial or pericardial blushing), and III (contrast streaming or cavity spilling). Types I and II coronary perforations are caused by stiff or hydrophilic guidewires. Type I has a benign prognosis, whereas type II coronary perforations have the potential to progress to tamponade. Type III coronary perforations are caused by balloons, stents, or other intracoronary devices and commonly lead to cardiac tamponade necessitating pericardial drainage. However, type III perforations can be managed with covered stents without need for surgical intervention.


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