Case study: a Ramus Type III perforation

Case study: a Ramus Type III perforation

Complications - Coronary perforation

Consult this case study on a Ramus Type III perforation, female 80-year old patient.


  • Age
  • Female gender
  • Over-sized non-compliant balloon pre-dilatation (balloon-to-artery ratio >1.2)


  • Immediate balloon tamponade and haemodynamic stabilisation
  • 2nd generation covered-stent (good crossability)
  • Post-dilatation of covered stent may be needed to achieve complete sealing of perforation
  • Fluoroscopic guided pericardiocentesis
  • Urgent reversal of anticoagulation
  • Immediate and early echocardiogram

For further reading, please consult Link 3 - Choice of covered stent


This case report does not reflect the opinion of PCR or PCRonline, nor does it engage their responsibility.