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Coronary fat embolization for late coronary perforation. I did a routine DK-crush bifurcation PCI. 6 hours later, pt is hypotensive with a large effusion. Relook angio showed diagonal tip perforation that wasnt there at the end of PCI. Prolonged balloon tamponade failed. Coils unavailable. Treated with autologous fat embolization,...

28,449 görüntüleme • 5 ay önce •via X (Twitter)

18 Yorum

Muhammet cihat çelik profil fotoğrafı
Muhammet cihat çelik5 ay önce

In a similar scenario I used a different technique: I kept the distal wire position, cut a small balloon, advanced the distal balloon segment over the wire beyond the perforation site, and used it as a mechanical plug. Final angiography showed complete seal.

sciqst profil fotoğrafı
sciqst5 ay önce

Interesting case, Anas. Hypotension with a large effusion post-PCI raises concerns. Could there have been vessel dissection or microvascular obstruction that wasn't evident initially? Was intravascular imaging utilized during the procedure to assess the stent placement? If yes, what findings did it reveal? #Medicine For a deeper dive into cases like this and to generate comprehensive biomedical reviews on similar topics, explore Sci-Quest, a one-stop platform for every biomedical question you might have:

Girish Viswanathan profil fotoğrafı
Girish Viswanathan5 ay önce

@Sh_Zaynobidinov Nice one..I did one for a RCA perforation. Really did the job. Thanks for sharing

Abhinav Aggarwal MD,DM profil fotoğrafı
Abhinav Aggarwal MD,DM5 ay önce

We did a recent case similarly. We also injected the distal end of coronary wire after cutting it

Anas T. Noman profil fotoğrafı
Anas T. Noman5 ay önce

Yes, that works too.

Samar Arfeen MBBS FCPS profil fotoğrafı
Samar Arfeen MBBS FCPS5 ay önce

Daring rescue

Ziad Storyteller profil fotoğrafı
Ziad Storyteller5 ay önce

Impressive bailout technique. Autologous fat embolization is an elegant solution when conventional methods fail. I look forward to TCT ME 2026.

Hazim Rahbi profil fotoğrafı
Hazim Rahbi5 ay önce

@AlkashkariWail Great save Anas

Jay profil fotoğrafı
Jay5 ay önce

Great case. Do u recommend mixing fat with contrast?

Anas T. Noman profil fotoğrafı
Anas T. Noman5 ay önce

I didnt do it in this case. I think its helpful to do though.

fbalex1907 profil fotoğrafı
fbalex19075 ay önce

What about the risk of infection?

Anas T. Noman profil fotoğrafı
Anas T. Noman5 ay önce

Probably similar to coils. No head to head comparison. Although if you look up the data, you might conclude that infection risk is higher with coils than fat embolism.

muhammadwaqas profil fotoğrafı
muhammadwaqas5 ay önce

great save

Doç. Dr. Hüseyin Katlandur profil fotoğrafı
Doç. Dr. Hüseyin Katlandur5 ay önce

👏🏻👏🏻👏🏻

Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res) profil fotoğrafı
Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)5 ay önce

What is the advantage over using a coil ?

Anas T. Noman profil fotoğrafı
Anas T. Noman5 ay önce

Only when you don’t have coils

Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res) profil fotoğrafı
Vikram Sharma MD, FACC, FSCAI, MRCP(UK), MD(Res)5 ay önce

Absolutely

joseph r motolenich profil fotoğrafı
joseph r motolenich4 ay önce

@Almanfi_Cardio Bravo! Great medicine and happy patient!

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