How to treat distal coronary perforations

Step-by-step description of how to treat a distal vessel perforation during percutaneous coronary interventions. The Universal Algorithm for treating coronary perforations should be used first inflating a balloon proximal to the perforation to stop pericardial bleeding. Sealing the perforated segment can be achieved with fat or coil embolization using the "block and deliver" technique (a balloon if inflated proximal to the perforated segment and a microcatheter is advanced next to this balloon allowing fat or coil delivery while proximal hemostasis is achieved).

[@harsh4082000]

Manos- it would be great if you can give a lecture on pericardiocentesis and tips and tricks- flouro and echo guided.

[@Torsade101]

Great video. Thanks.

[@shangz0216]

Thanks for the educative sharing.

[@maisamtaherian986]

Thank you so much

[@harsh4082000]

fantastic

[@77bansal]

Thanks sir for learning tips

[@durgaprasad-nv2cd]

Thank you so much sir...

[@dr.ajab-kharoty1299]

Now it cleared my concept , thanx alot sir 🤲🤲

[@TheNEF11]

Thank you very much sir. What kind of Medtronic Axium coils do you prefer most?although I know that it depends what sie the vessel is, it would be very nice to have a short explanation about the prefered Size? length? Helical or 3D, a picture of the box of the preferred coil (Axium) would be perfect. Thank you very much again!

[@manosbrilakis]

Axium 3D 2mm x 2cm, 2mm x 4 cm, 2.5 mm x 2cm, and 2.5 mm x 4 cm.

[@mohamedadam9391]

Thanks alot if I have no microcath in my cath lab any tip to deliver fat distally ???

[@aramic1975]

Thanks a lot for your teaching Methods! Do you have a Manual for treating coronary dissection? Thanks in advance

[@manosbrilakis]

Not yet - coming later this year. Thank you, Manos

[@aramic1975]

Thank you ! Do you have until then a link or a source you can tell me? Thanks

[@micger]

Does that mean you have exchange your sheath and guide to 8Fr for the block and deliver technique?

[@manosbrilakis]

You do not have time for that. If you have an 8 French sheath and guide in place, great. If not, you should use the ping pong technique (deliver the blocking balloon through the existing guide and get a second guide to engage the vessel and deliver coils, fat, or a covered stent).