A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula

Coronary artery perforation (CAP) is a rare, but potentially mortal possible complication of percutaneous coronary intervention. There are several treatment options for this complication, including prolonged balloon dilatation, use of a coronary stent graft, and bypass surgery. In this case report,...

Full description

Bibliographic Details
Main Authors: Kayıhan Karaman, Metin Karayakalı, Arif Arısoy, İlker Akar, Ataç Çelik
Format: Article
Language:English
Published: KARE Publishing 2017-12-01
Series:Türk Kardiyoloji Derneği Arşivi
Subjects:
Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-77823
_version_ 1797916024364859392
author Kayıhan Karaman
Metin Karayakalı
Arif Arısoy
İlker Akar
Ataç Çelik
author_facet Kayıhan Karaman
Metin Karayakalı
Arif Arısoy
İlker Akar
Ataç Çelik
author_sort Kayıhan Karaman
collection DOAJ
description Coronary artery perforation (CAP) is a rare, but potentially mortal possible complication of percutaneous coronary intervention. There are several treatment options for this complication, including prolonged balloon dilatation, use of a coronary stent graft, and bypass surgery. In this case report, a 65-year-old female patient who was admitted to the catheter laboratory with a diagnosis of acute coronary syndrome, was presented. Coronary angiography revealed total occlusion in the mid segment of the right coronary artery and a drug-eluting stent was implanted under 12 atm of pressure following pre-dilatation with a perfusion balloon. In order to perform defragmentation of the thrombus shifted into the proximal stent segment, post-dilatation was performed with a stent balloon (4–6 atm). After post-dilatation, an Ellis Class II perforation developed. In order to control the bleeding, a coronary stent graft was implanted at the perforation area. The rupture was sealed. Control coronary angiography 40 days later indicated that the stent graft was patent, but an arteriovenous fistula (AVF) draining to the right ventricle was detected. To the best of our knowledge, this is the first case of AVF seen as a late complication of CAP treated with a stent graft.
first_indexed 2024-04-10T12:50:36Z
format Article
id doaj.art-864ea19d150743a3b143001648ff6426
institution Directory Open Access Journal
issn 1016-5169
language English
last_indexed 2024-04-10T12:50:36Z
publishDate 2017-12-01
publisher KARE Publishing
record_format Article
series Türk Kardiyoloji Derneği Arşivi
spelling doaj.art-864ea19d150743a3b143001648ff64262023-02-15T16:13:49ZengKARE PublishingTürk Kardiyoloji Derneği Arşivi1016-51692017-12-0145873974310.5543/tkda.2017.77823TKDA-77823A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistulaKayıhan Karaman0Metin Karayakalı1Arif Arısoy2İlker Akar3Ataç Çelik4Department of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, TurkeyDepartment of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, TurkeyDepartment of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, TurkeyDepartment of Cardiovascular Surgery, Gaziosmanpaşa University Faculty of Medicine, Tokat, TurkeyDepartment of Cardiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, TurkeyCoronary artery perforation (CAP) is a rare, but potentially mortal possible complication of percutaneous coronary intervention. There are several treatment options for this complication, including prolonged balloon dilatation, use of a coronary stent graft, and bypass surgery. In this case report, a 65-year-old female patient who was admitted to the catheter laboratory with a diagnosis of acute coronary syndrome, was presented. Coronary angiography revealed total occlusion in the mid segment of the right coronary artery and a drug-eluting stent was implanted under 12 atm of pressure following pre-dilatation with a perfusion balloon. In order to perform defragmentation of the thrombus shifted into the proximal stent segment, post-dilatation was performed with a stent balloon (4–6 atm). After post-dilatation, an Ellis Class II perforation developed. In order to control the bleeding, a coronary stent graft was implanted at the perforation area. The rupture was sealed. Control coronary angiography 40 days later indicated that the stent graft was patent, but an arteriovenous fistula (AVF) draining to the right ventricle was detected. To the best of our knowledge, this is the first case of AVF seen as a late complication of CAP treated with a stent graft.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-77823arteriovenous fistulacoronary artery perforation; percutaneous coronary intervention; stent graft.
spellingShingle Kayıhan Karaman
Metin Karayakalı
Arif Arısoy
İlker Akar
Ataç Çelik
A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
Türk Kardiyoloji Derneği Arşivi
arteriovenous fistula
coronary artery perforation; percutaneous coronary intervention; stent graft.
title A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
title_full A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
title_fullStr A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
title_full_unstemmed A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
title_short A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula
title_sort late complication of coronary artery perforation during primary percutaneous coronary intervention coronary arteriovenous fistula
topic arteriovenous fistula
coronary artery perforation; percutaneous coronary intervention; stent graft.
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-77823
work_keys_str_mv AT kayıhankaraman alatecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT metinkarayakalı alatecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT arifarısoy alatecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT ilkerakar alatecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT ataccelik alatecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT kayıhankaraman latecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT metinkarayakalı latecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT arifarısoy latecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT ilkerakar latecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula
AT ataccelik latecomplicationofcoronaryarteryperforationduringprimarypercutaneouscoronaryinterventioncoronaryarteriovenousfistula