Emergency management - Type V: Distal segment
Perforation of the distal segment
Type V coronary perforation takes a look at perforation of the distal segment due to coronary guidewire tip exiting the coronary artery distally.
Table of content
- Introduction Type V
- Management algorithm
- Additional links
- Case library
- Post-procedural care
Introduction
Management algorithm
Type V coronary artery perforations may be initially missed as the leak into the pericardium is often small and may requiring panning to the distal vessel to be appreciated. Management may require embolisation of the distal vessel with thrombin, coils or fat. Beware of collateral flow to the affected territory which can cause the perforation to persist despite apparently successful embolisation.
Additional links
Link 1 - Inflate balloon at perforation site
Link 4 - Thrombin injection
Link 5 - Coil embolisation
Link 6 - Autologous subcutaneous fat embolisation
Case library
Consult the 1st Case study: distal perforation coils
Consult the 2nd Case study: reverse heparin
Consult the 3rd Case study: thrombin injection
Disclaimer
This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.