Uso de duplo cateter-guia como auxílio para tratamento de perfuração coronariana durante angioplastia primária

Coronary perforation during percutaneous coronary intervention: description of a salvage technique

“…6,9,11,12 The use of covered stents has shown satisfactory results, with perforation closure in more than 90% of cases. 10 A common problem is that interventional cardiology services do not have this device available, or there is not a device of adequate size for the target vessel, or the device is available, but it is out of date. If covered stents or microspheres are not available, and given the potential severity of the case, as a salvage measure, we opted to use a PTFE mesh cut out from a balloon catheter, covering a stent, and fixed with gauze threads, simulating a covered stent.…”

“…13 To minimize the time of blood extravasation to the pericardium and increase the speed of the device exchange, the puncture of another arterial site, with subsequent catheterization of the same coronary artery, can be used, known as the doubleguide catheter technique, commonly used when there is a need to implant a covered stent. 9,10 In the case reported here, after identifying the perfora tion of the coronary artery, classified as Ellis type II, it was initially decided to occlude the perforation, using prolon ged inflation of a balloon catheter, but without success. It was then decided to occlude the lesion segment by implan ting another stent, using a double guide catheter technique.…”

Tratamento de perfuração coronária tipo IV durante intervenção coronária percutânea

“…16 The double-guide catheter technique may be used to minimize blood leakage into the pericardial when the coated stent implantation is necessary. 17 This technique consists of a subselective catheterization of the coronary artery ostium through a second guide catheter, after obtaining a second access route, while keeping the containment balloon inflated at the perforation site. Through this catheter, the coated stent is delivered to seal the perforation.…”