Simple and inexpensive way for the treatment of guidewire-induced distal coronary perforation: subcutaneous fat tissue embolization

cardial infarction was admitted to the catheterization laboratory for primary percutaneous coronary intervention. Left anterior descending artery (LADa) was seen subtotally occluded immediately after the first diagonal artery (D1a) branching with TIMI 1 distal flow on coronary angiogram (Fig. 1a–c, Video 1–3). LADa and D1a were passed by a soft guidewire. After predilatation of the culprit lesion, guidewire-induced coronary perforation was noticed at the distal segment of D1a (Fig. 1d, Video 4). After 20 min inflation of balloon (Fig. 1e, f) at the perforation segment and culprit lesion treated by stent implantation, extravasation was found to be diminished (Fig. 1g, h, Video 5, 6). Echocardiography revealed minimal pericardial effusion without tamponade sign. On the development of clinical and echocardiographic tamponade signs at the first hour, fluorosAnatol J Cardiol 2016; 16: E-21-24 E-page Original Images E-23