Department of Cardiology, 108 Central Military Hospital, Hanoi, Vietnam.
Vinuniversity College of Health Sciences, Hanoi, Vietnam.
Am J Case Rep. 2023 Feb 3;24:e938861. doi: 10.12659/AJCR.938861.
BACKGROUND Coronary artery perforation is a rare complication of percutaneous coronary intervention for coronary artery occlusion. This report is of 2 cases of coronary artery perforation during percutaneous coronary intervention that were managed successfully using injection of combined Histoacryl (n-Butyl-2-Cyanoacrylate) and Lipiodol (ethiodized oil). CASE REPORT Case 1 was a 51-year-old man with a past medical history of hypertension, dyslipidemia, and multivessel coronary disease. He was admitted to our hospital with inferior wall myocardial infarction, and a stent was placed in the proximal right coronary artery. He also had chronic total occlusion (CTO) of the left anterior descending artery (LAD). The planned LAD CTO intervention was complicated by balloon-induced coronary perforation and was managed successfully with intracoronary injection of Histoacryl-Lipiodol mixtures via microcatheter. He was discharged in stable condition without any serious consequences. Case 2 was a 72-year-old man with underlying hypertension who was admitted to the hospital with diagnosis of unstable angina. The diagnostic angiography showed occlusion of the LAD, CTO of the left circumflex artery, and minor atherosclerosis in right coronary artery. A stent was placed in the mid-LAD without any complications. Subsequently, a planned left circumflex artery CTO intervention was complicated by wire-induced coronary perforation, which was treated successfully with injection of Histoacryl-Lipiodol mixture. The patient was discharged in good condition. CONCLUSIONS Histoacryl and Lipiodol injection was a rapid and effective management method in 2 rare cases of coronary artery perforation during percutaneous coronary intervention.
经皮冠状动脉介入治疗（PCI）中冠状动脉穿孔是一种罕见的并发症。本报告介绍了 2 例成功应用Histoacryl（正丁基-2-氰基丙烯酸酯）和Lipiodol（碘油）混合注射治疗的 PCI 术中冠状动脉穿孔病例。
病例 1 为 51 岁男性，既往有高血压、血脂异常和多支血管性心脏病病史。因下壁心肌梗死入院，于右冠状动脉近端置入支架，同时存在左前降支（LAD）慢性完全闭塞（CTO）病变。拟行 LAD CTO 介入治疗时发生球囊诱导的冠状动脉穿孔，通过微导管成功进行了冠状动脉内Histoacryl-Lipiodol 混合液注射治疗，患者病情稳定出院，未出现严重后果。病例 2 为 72 岁男性，有基础高血压病史，因不稳定型心绞痛入院。诊断性冠状动脉造影显示 LAD 闭塞、左回旋支 CTO 和右冠状动脉轻度粥样硬化。于 LAD 中段成功置入支架，随后计划行左回旋支 CTO 介入治疗时发生导丝诱导的冠状动脉穿孔，通过注射Histoacryl-Lipiodol 混合液成功治疗，患者病情稳定出院。
在 2 例罕见的 PCI 术中冠状动脉穿孔病例中，Histoacryl 和 Lipiodol 注射是一种快速有效的治疗方法。
