Effect of transcatheter embolization by tissue adhesive histoacryl in treatment of coronary artery perforation during percutaneous coronary intervention

Aim. Coronary artery perforation (CAP) is a rare but severe complication of percutaneous coronary intervention (PCI). The aim of our study was to evaluate the effect and safety of transcatheter embolization by tissue adhesive Histoacryl when treating CAP. Methods. As CAP was confirmed, the final composition of the tissue adhesive histoacryl and radiopaque agent Lipiodol was prepared. The perforated vessel was embolized by tissue adhesive Histoacryl via a micro-catheter. There were eleven patients undergoing transcatheter embolization by Histoacryl in treatment of CAP during PCI at Meshalkin Novosibirsk Research Institute of Circulation Pathology from March 2013 to February 2016, and the clinical data of these patients were collected and analyzed retrospectively. Results. The lesion morphology of the patients was classified by using the American College of Cardiology/American Heart Association T ask Force classification, there were four patients with Class B2 lesions and seven patients with Class C lesions (there also were four patients with chronic total occlusion lesions). According to the Ellis classification of CAP, there were five patients with Class II perforations and six patients with Class III perforations. The causes of perforation were a guide wire (ten patients) and balloon predilation (one patient). Three patients had pericardial effusion. All of the eight patients with CAP underwent transcatheter embolization by Histoacryl. Coronary angiography confirmed that all of them had been embolized successfully. There were no severe postoperative complications. Conclusion. Transcatheter embolization by Histoacryl is an effective, safe, cheap, and easy way to treat perforation of small vessels during PCI.