Successful Management with Coated Stent of Osteal Perforation of Left Anterior Descending Artery due to Laser Angioplasty

Coronary perforation is a rare complication of percutaneous coronary intervention. We report a case of osteal left anterior descending artery perforation and cardiac tamponade during excimer laser angioplasty on primary angioplasty of acute myocardial infarction. Perforation was successfully covered with PTFE-coated stent. Pericardial tamponade was decompressed with the aim of a 6-French pigtail advanced into the pericardium via arterial sheath. At open-heart surgery the site of perforation was repaired primarily, and left internal mammarian artery to left anterior descending by-pass grafting was performed.