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Lesser known coronary stents : This one rescues cardiologists out of cath lab !

Posted Jul 15 2010 3:01am

Coronary stent implantation , which   was once  considered  , a state of the art procedure is now   practiced even  in,  remote towns and small nursing homes all over the world.

While , it is a blessing to  have such a technology disseminate all over , we have also  witnessed problems due to indiscriminate work ethics inside human coronary arteries. One of the deadly complication  is coronary artery perforation.( It is not a surprise to experience this complication , especially  when inexperienced, cardiologists  try to manoeuvre fancy hardwares  into the coronary artery for the first time !)

Ellis , fore- saw this yeas ago !

He classified coronary artery perforation into three types.

For type 3 perforation , the   only emergency intervention is deploying a stent graft .

A  covered stent with    Polytetra fluro ethylene   (PTFE)( Jostent ) is often used .

Final message

  • Anticipate this complication  , especially when negotiating CTOs and fragile venous grafts , or  while dealing  any complex lesion.
  • Every cathlab should have a crash cart ready with anti perforation kit .( A large bore needle to tap tamponade is much more important than a PTFE stent graft !)
  • Referring for an emergency surgery is one option , but it is often too late !

 


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