Balloon Fragment Technique Used to Close Distal Coronary Vessel Perforation.

Aims 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. Methods 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. Conclusion 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.