Coronary perforation during balloon anchoring after rotational atherectomy of chronic total occlusion of coronary vessel

An 87-year-old Asian male experienced progressive shortness of breath for two days. He presented symptoms and signs of decompens-ated heart failure and was diagnosed as non ST-segment elevation myocardial infarction, killip III. Coronary intervention was performed for chronic total occlusion of left anterior descend-ing artery. Unfortunately, coronary perforation happened during balloon anchoring after rotational atherectomy. Rotational atherectomy may be not related to perforation, but causes vessel wall more fragile after disruption of the arc of calcification. Even if balloon anchoring was performed at low pressure, we need keep in mind that it still could result in a terrible coronary perforation after debulking techniques. Covered stents for emergency implantation in case of coronary perforation must be an obligatory inventory of catheterization laboratories. It is an effective alternative that can be used to seal a major coronary perforation. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 10, October 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(10):666–670. www.ijcasereportsandimages.com Lee et al. 666 CASE REPORT OPEN ACCESS Coronary perforation during balloon anchoring after rotational atherectomy of chronic total occlusion of coronary vessel Wei-Chieh Lee, Chiung-Jen Wu, Hsiu-Yu Fang