We read with interest the paper, Guidewire Induced Coronary Perforation Successfully Treated with Subcutaneous Fat Embolization: A Simple Technique Available To All, the case report of a guidewire perforation successfully treated with subcutaneous fat [1]. We agree that perforations of the coronaries can be fatal and they are particularly frustrating when they occur in a small vessel.We were the first to report the use of clotting agents also available to all to resolve a perforation in a patient we treated over 15 years ago [2]. In this case, we used autologous blood in a patient with a perforated vessel at our institution. As we reported, this woman came in after myocardial infarction, had been pretreated with TPA as well as glycoprotein inhibitors and suffered a perforation of her left anterior descending during simple balloon angioplasty of her occluded vessel after an anterior wall myocardial infarction. With a glycoprotein inhibitor and TPA still on board as well as heparin, we were in a dilemma. Even though our institution was the site that first invented, developed, and reported the use of the PTFE covered coronary stent, at that time, no device was commercially available to the United States and the vessel was too small for our large handmade and homemade device [3]. As happens in many cath labs around the world, a quick thinking X-ray tech recommended that we might want to consider putting autologous blood in, something we had seen done in a patient who had liver biopsy where they continued to bleed after removing the biopsy material.We mixed protamine with heparin and infused this thrombus down the LAD with a peripheral balloon catheter. We could not fit it through 0.014 catheter system because the slurry was fairly thick. When we administered this autologous blood mixed with protamine, the vessel completely occluded. Then we were able to safely pass a wire across and then performed balloon angioplasty and gentle stenting with resolution of the perforation. Unlike this case, where the fat embolization resulted in the total occlusion of the vessel, we were able to maintain patency because we were able to recanalize the thrombus, we created with a 0.014 wire down the vessel.Again, it is imperative that physicians have something available for this complication, although it does not occur that often. Subcutaneous fat is one option; however, it does require a surgical incision and the delay can be devastating. In our case, we were able to use the patient's own blood to thrombose the vessel with resolution of the perforation and tamponade.