Successful nonsurgical management of coronary artery perforation aided by implantation of a bare stent

Coronary artery perforation complicating percutaneous transluminal coronary angioplasty (PTCA) is rare but can be potentially fatal. We report a case of coronary artery dissection and perforation during PTCA that was successf ully treated by implanting a bare stent with disappearance of angiographic contrast extravasation and performing one-time pericardiocentesis for unexp ected delayed cardiac tamponade thereby avoiding the need for surgery. The possibility of coronary angiography not detecting a small residual leak fro m the perforation is also discussed.