A case of huge coronary perforation during insertion of a long stent in severe calcified bifurcation lesion

A case of huge coronary perforation during insertion of a long stent in severe calcified bifurcation lesion Author: Yoshinobu Murasato, MD, PhD, Kyushu Medical Center, Japan Take home messages: • A long stent insertion in the calcified bifurcation lesion led to stack of the stent and S-figure flection which resulted in huge coronary perforation. • The situation that 1/3 of the stent remained in the guiding catheter might induce strong push-ability to make S-figure flection in the coronary artery. • When we feel hard resistance during insertion of a long stent, we should consider another option as the following earlier. Biplane fluoroscopy for detailed observation of the stent stack Buddy wire to change the wire bias Guide extension catheter to enhance back-up force and prevent the stent flection inside the coronary artery.