Although rare in the stent era, coronary artery perforation
(CAP) may cause myocardial infarction, repeat percutaneous
coronary intervention (PCI), or even death in
5–10% of cases (depending on the severity of the perforation)
[1]. Here, we present a case of type-V CAP complicating
primary PCI for anterior ST-segment elevation
myocardial infarction.
A 48-year-old man with history of diabetes mellitus
presented with acute progressive chest pain of 12-hour
duration. ECG showed evidence of anterior ST-segment
elevation myocardial infarction. He underwent primary
PCI (door to device time: 60 minutes) with implantation
of two overlapping drug-eluting stents (2.5 × 18 mm
distally and 2.75 × 22 mm proximally) to the left anterior
descending artery (LAD). The patient’s chest pain
disappeared, and he was hemodynamically stable with
blood pressure of 130/80 mmHg. Angiography showed
satisfactory stent results, but minor contrast extravasation
was observed in the distal LAD segment