1st Military Hospital in Lublin, Lublin, Woj. Lubelskie, Poland.
J Invasive Cardiol. 2020 Dec;32(12):E370-E372. doi: 10.25270/jic/20.00244.
Coronary artery perforation is a rare but potentially serious complication of percutaneous coronary intervention (PCI). Clinical manifestation and prognosis of patients depend on the severity of the complication, the occurrence of tamponade, and the methods of treatment. A special type of perforation is caused by damage to the distal segment of the coronary vessel by guidewire. This type of perforation is mostly connected with subacute clinical presentation. The treatment can be difficult, especially when prolonged balloon inflation is not efficient. The aim of the article is to present a balloon fragment technique as a treatment method for distal vessel perforation.
The method of treating distal perforation, which we presented at EuroPCR 2019, involves embolization of a perforated vessel with a cut part of balloon catheter. Six patients are included in this registry; only 1 truncated proximal balloon fragment was enough to effectively embolize the perforated vessel in 4 patients, while 2 balloons were required in 1 patient and 3 balloons were required in 1 patient.
Compared with other methods, this technique is an easy, cheap, and effective treatment for distal vessel perforation. The described method is available in every catheterization laboratory and does not require expensive equipment or exceptional operator experience.
冠状动脉穿孔是经皮冠状动脉介入治疗（PCI）的一种罕见但潜在严重的并发症。患者的临床表现和预后取决于并发症的严重程度、是否发生心脏压塞以及治疗方法。一种特殊类型的穿孔是由导丝损伤冠状动脉远端段引起的。这种类型的穿孔大多与亚急性临床表现有关。治疗可能很困难，尤其是当长时间球囊扩张无效时。本文旨在介绍一种球囊碎片技术作为治疗远端血管穿孔的方法。
我们在 2019 年 EuroPCR 上提出的治疗远端穿孔的方法涉及用切割的球囊导管部分栓塞穿孔的血管。本注册研究纳入了 6 名患者；在 4 名患者中，仅 1 个截断的近端球囊碎片就足以有效地栓塞穿孔的血管，而在 1 名患者中需要 2 个球囊，在 1 名患者中需要 3 个球囊。
与其他方法相比，该技术是一种治疗远端血管穿孔的简单、廉价且有效的方法。所描述的方法可在每个导管室使用，不需要昂贵的设备或特殊的操作经验。
