Coronary artery perforations (CAP) are rare in patients undergoing routine PCI with recent contemporary databases reporting an incidence ∼0.3%. Older age, cardiomyopathy or left ventricular dysfunction, mechanical circulatory support prior to PCI, and CTO lesions have the strongest association with CAP. Prevention, early detection, preparedness and familiarity with the equipment used to treat perforations (such as efficient use of covered stents, and fat or coil embolization) and regrouping to examine and educate about these experiences are key for improving our response to cath lab disasters.
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