A patient was referred for PCI of the right coronary artery and the LAD. The RCA had a severe, heavily calcified distal lesion. Equipment delivery to the RCA lesion failed through radial access despite using a guide extension. After changing to femoral access with an 8 French AL1 guide and a guide extension a balloon could be delivered to the RCA lesion but the lesion was balloon undilatable. The lesion expanded after high-pressure inflation with a NC balloon but the balloon ruptured causing a dissection/perforation. The patient remained hemodynamically stable and echo showed a small pericardial effusion. There was no improvement after placing a drug-eluting stent. A 3.5x26 mm PK Papyrus covered stent was delivered decreasing but not eliminating the extravasation. Eventually the perforation was sealed after a 2nd PK Papyrus stent was delivered and deployed more proximally in the lesion.
- 2 ай бұрын
Case 170: Manual of PCI - Covered stent did not work
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