[A simple but very complicated angioplasty: management of coronary artery perforation and dual antiplatelet therapy. A case report and literature review]

G Ital Cardiol (Rome). 2015 May;16(5):311-5. doi: 10.1714/1870.20436.
[Article in Italian]

Abstract

Coronary artery perforation is a rare but potentially fatal complication. Therefore, it is crucial for interventional cardiologists to have knowledge of this condition and what management strategies are available, particularly in the case of procedures with a high level of complexity. Notwithstanding this, even simple procedures are not immune to serious complications, as described in this case report where coronary angioplasty was complicated by left anterior descending artery perforation with cardiac tamponade, giving rise to multiple complications of difficult management. The case presented here also provides the opportunity to investigate the optimal duration of dual antiplatelet therapy after implantation of drug-eluting stents, a topic much debated in recent years.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Anticoagulants / therapeutic use
  • Cardiac Tamponade / etiology*
  • Cardiac Tamponade / therapy
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / injuries*
  • Drug-Eluting Stents / adverse effects*
  • Everolimus
  • Heparin / therapeutic use
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Male
  • Myocardial Infarction / therapy
  • Paclitaxel / pharmacology
  • Percutaneous Coronary Intervention / methods
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Reoperation
  • Sirolimus / analogs & derivatives
  • Sirolimus / pharmacology
  • Thrombosis / drug therapy
  • Thrombosis / etiology*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Immunosuppressive Agents
  • Platelet Aggregation Inhibitors
  • Heparin
  • Everolimus
  • Paclitaxel
  • Sirolimus