PMC10285455_01
Case timeline.
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Figure 1 presents the case timeline.
(a) CAG showed a perforation at the stent of mid-LAD. (b) CAG confirmed an Ellis type III CP at the stent. (c) CAG showed diffusive thrombus in the mid ostium of LAD without contrast extravasation. (d) After aspiration, LAD recovered patency, but the contrast agent extravasation reoccurred. (e) Prolonged balloon inflation was performed in situ of perforation. (f) Contrast agent extravasation persisted after 3 times of balloon inflation in situ. (g) Prolonged balloon inflation was performed at the proximal site of the perforation. (h) CAG showed no contrast agent extravasation.
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CAG showed a CP at the stent of the mid-LAD (Figure 2a). Repeat angiography confirmed an Ellis type III CP at the stent implantation site (Figure 2b). CAG showed a diffusive thrombus in the mid ostium of the LAD without contrast extravasation, indicating that the perforation had healed (Figure 2c). Considering the benefit of the anterior descending branch, we aspirated the thrombus to avoid further occlusion. After aspiration, the anterior descending artery recovered patency, but contrast agent extravasation occurred (Figure 2d). A contrast agent was administered to confirm that the blood vessel had been fully blocked (Figure 2e). Contrast agent extravasation persisted at the perforation site on the angiogram after 3 balloon occlusions (Figure 2f). We dragged the balloon to the proximal site of the CP and inflated it again to block the blood flow (Figure 2g). Repeat angiography showed no contrast agent extravasation and no obvious thrombosis reformed in the stent (Figure 2h).