Percutaneous safenectomy: A potentially dreadful complication of cutting balloon angioplasty in safenous vein grafts

Worawut Tassanawiwat, Giuseppe G L Biondi-Zoccai, Giuseppe Sangiorgi, Ioannis Iakovou, Eleutheria Tsagalou, Gloria Melzi, Lei Ge, Nuccia Morici, Nicola Corvaja, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

Vessel perforation is an uncommon but potentially life-threatening complication of percutaneous coronary intervention and is often associated with the use of atheroablative devices. While effective management means are currently available, such as PTFE-covered stent, pericardiocentesis, and perfusion balloon, a timely and skillful approach is of paramount importance to solve this dreadful complication. We hereby describe a case of saphenous vein graft (SVG) perforation occurring after cutting balloon angioplasty for in-stent restenosis. Despite the immediate occurrence of cardiac arrest due to massive extravasation of contrast in the mediastinum with pericardial tamponade, deep catheter intubation enabled the deployment of two PTFE-covered stents and subsequent sealing of the leak with repeated inflation of a perfusion balloon, while hemopericardium was drained by pericardiocentesis. This clinical vignette emphasizes the role of optimal backup in order to deploy life-saving devices and successfully manage life-threatening pericardial tamponade due to SVG rupture.

Original languageEnglish
Pages (from-to)418-419
Number of pages2
JournalInternational Journal of Cardiology
Volume106
Issue number3
DOIs
Publication statusPublished - Jan 26 2006

Keywords

  • Cardiac tamponade
  • Cutting balloon
  • Stent
  • Vessel perforation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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