Successful management of coronary artery perforation with drug-coated balloon: a case report

Abstract

Abstract Background Coronary artery perforation (CAP) is a rare but serious complication of Percutaneous coronary intervention (PCI) with significant morbidity and mortality. Traditional management involves the use of covered stents, yet alternative interventions may be necessary. To report a unique case of CAP managed effectively with a drug-coated balloon, highlighting a novel application of this technology in emergency PCI. Case presentation A 73-year-old male with a history of chronic angina, hypertension, and diabetes underwent PCI for severe stenosis in the mid-left anterior descending (LAD) artery. During the procedure, a large vessel CAP occurred. Immediate management included hemodynamic stabilization via fluid resuscitation and dopamine administration, followed by the deployment of drug-coated balloons instead of the conventional covered stent to seal the perforation. The intervention successfully sealed the perforation with restoration of thrombolysis in myocardial infarction 3 flow, and the patient remained hemodynamically stable. Follow-up over six months showed no adverse cardiovascular events and normal cardiac function was maintained. Conclusions This case demonstrates the potential of drug-coated balloons as a feasible alternative to covered stents in managing CAP, particularly in large vessel perforations. Further research is warranted to assess the long-term safety and efficacy of this approach.

Keywords

• Coronary artery disease
• Percutaneous coronary intervention
• Coronary artery perforation
• Drug-coated balloon
• Chronic total occlusion