High Success Rate in Sealing Distal Coronary Artery Perforations Using Absorbable Gelatin Sponge

Abstract

Coronary artery perforation (CAP) is a major complication of percutaneous coronary intervention (PCI). The management of CAP can be challenging, requiring tailored approaches based on specific clinical scenarios. We are reporting outcome data on six patients who experienced distal CAP during PCI and were 100% successfully treated using absorbable gelatin sponge embolization without procedural or immediate postprocedural complications.

Keywords

complications - PCI - stenting - balloon - perforation - embolization

Publication History

Article published online:
06 December 2024

• References

• 1 Al-Mukhaini M, Panduranga P, Sulaiman K, Riyami AA, Deeb M, Riyami MB. Coronary perforation and covered stents: an update and review. Heart Views 2011; 12 (02) 63-70
• 2 Ellis SG, Ajluni S, Arnold AZ. et al. Increased coronary perforation in the new device era. Incidence, classification, management, and outcome. Circulation 1994; 90 (06) 2725-2730
• 3 Rogers JH, Lasala JM. Coronary artery dissection and perforation complicating percutaneous coronary intervention. J Invasive Cardiol 2004; 16 (09) 493-499
• 4 Fasseas P, Orford JL, Panetta CJ. et al. Incidence, correlates, management, and clinical outcome of coronary perforation: analysis of 16,298 procedures. Am Heart J 2004; 147 (01) 140-145
• 5 Ramana RK, Arab D, Joyal D. et al. Coronary artery perforation during percutaneous coronary intervention: incidence and outcomes in the new interventional era. J Invasive Cardiol 2005; 17 (11) 603-605
• 6 Witzke CF, Martin-Herrero F, Clarke SC, Pomerantzev E, Palacios IF. The changing pattern of coronary perforation during percutaneous coronary intervention in the new device era. J Invasive Cardiol 2004; 16 (06) 257-301
• 7 Javaid A, Buch AN, Satler LF. et al. Management and outcomes of coronary artery perforation during percutaneous coronary intervention. Am J Cardiol 2006; 98 (07) 911-914
• 8 Teis A, Fernández-Nofrerías E, Rodríguez-Leor O. et al. Coronary artery perforation by intracoronary guide wires: risk factors and clinical outcomes. Rev Esp Cardiol 2010; 63 (06) 730-734
• 9 Shirakabe A, Takano H, Nakamura S. et al. Coronary perforation during percutaneous coronary intervention. Int Heart J 2007; 48 (01) 1-9
• 10 Dixon SR, Webster MW, Ormiston JA, Wattie WJ, Hammett CJ. Gelfoam embolization of a distal coronary artery guidewire perforation. Catheter Cardiovasc Interv 2000; 49 (02) 214-217
• 11 Kałmucki P, Kuzemczak M, Siminiak T, Baszko A. Emergency treatment of iatrogenic coronary perforation by transcatheter embolization with gelatin sponge particles-description of technique. Catheter Cardiovasc Interv 2019; 94 (02) 223-226
• 12 Kawano H, Arakawa S, Satoh O, Matsumoto Y, Hayano M, Miyabara S. Foreign body granulomatous change from absorbable gelatin sponge and microcoil embolization after a guidewire-induced perforation in the distal coronary artery. Intern Med 2010; 49 (17) 1871-1874
• 13 Ekelund L, Månsson W, Olsson AM, Stigsson L. Palliative embolization of arterial renal tumour supply. Results in 10 cases. Acta Radiol Diagn (Stockh) 1979; 20 (02) 323-336
• 14 Ząbkowski T, Piasecki P, Zieliński H, Wieczorek A, Brzozowski K, Zięcina P. Superselective renal artery embolization in the treatment of iatrogenic bleeding into the urinary tract. Med Sci Monit 2015; 21: 333-337
• 15 Nathan A, Hashemzadeh M, Movahed MR. Percutaneous coronary intervention of chronic total occlusion associated with higher inpatient mortality and complications compared with non-CTO lesions. Am J Med 2023; 136 (10) 994-999