A Novel Technique for Managing Guidewire-Induced Distal Coronary Perforation Using Coronary Balloon Pieces

Alavi, Seyed Hosein; Hassanzadeh, Mani; Dehghani, Pooyan; Namdar, Zahra Mehdipour; Aslani, Amir

doi:10.1016/j.jaccas.2021.10.018

Cited by 1 publication

(1 citation statement)

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“…Since its first description in 2020, there have been very limited data (restricted to case reports and single-center case series) on the use of the CBT in clinical practice [15][16][17]. In this regard, our report is the first multicenter study to confirm the feasibility of CBT for the treatment of distal coronary perforations, adding yet another technique to the PCI armamentarium.…”

Section: Discussionmentioning

confidence: 94%

Embolization of Perforated Coronary Artery with a Fragment of Balloon Catheter (Cut Balloon Technique)—Multicenter Study

Sobieszek,

Zięba,

Dworzański

et al. 2023

JCDD

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Background: Iatrogenic distal coronary artery perforation can be a life-threatening complication. While there are different dedicated devices for the embolization of distal perforations, there are scarce data about the embolization using the fragmented balloon catheter, the so-called cut balloon technique (CBT). Methods: We included consecutive patients with distal coronary perforations treated with CBT in four cardiac centers between 2017 and 2023. Clinical, angiographic and procedural characteristics as well as in-hospital outcomes were recorded. Results: Twenty-six patients (68% men, mean age: 71 ± 10.6 years) with 25 distal coronary perforations and one septal collateral perforation were included. Eleven patients (42%) had elective percutaneous coronary intervention, while fifteen patients (58%) were treated for acute coronary syndrome. The site of perforation was most frequently distributed in the left anterior descending artery (40%), followed by the circumflex artery (28%) and right coronary artery (24%). The diameter of balloons for CBT ranged from 1.5 to 4.0 mm, with most balloons (76%) being either 2.0 or 2.5 mm in diameter. Most balloons (88%) were previously used for lesion predilatation. The numbers of cut balloons needed to seal the perforation were 1, 2 and ≥3 in 48%, 20% and 32% of cases, respectively. The in-hospital prognosis was favorable, with cardiac tamponade requiring pericardiocentesis in only four (16%) patients. Neither emergency surgery nor cardiac death occurred. Conclusions: CBT is a safe, efficient and easy-to-implement technique for the embolization of coronary perforations. Most distal coronary perforations can be sealed with one or two fragments of cut balloons, obviating the need for additional devices.

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Section: Discussionmentioning

confidence: 94%