MANAGEMENT OF CORONARY-ARTERY DISSECTION AND PERFORATION FOLLOWING CORONARY ANGIOPLASTY BY INTRA CORONARY STENT

Coronary artery perforation during percutaneous transluminal coronary angioplasty (PTCA) is a rare complication 0.003%-0.2%.(1-3) The incide nce of this complication has increased with the use of new coronary in terventional devices.(4,5) Angiographically there are three types of c oronary artery perforations, which are useful predictor of clinical se quelae, like myocardial infarction, emergency CABG and death.(1) The p erforations usually managed by observation, prolonged perfusion balloo n inflation, emergency CABG and recently by stent implantation (covere d or naked)(6) depending on the case. We hereby present a case report where PTCA to circumflex artery led to Type II A coronary artery perfo ration (diffuse pericardial staining) with dissection and TIMI grade 2 flow and its successful management with the implantation of a Palmaz- Schatz stent.