Emergency Platinum Coil Embolization in a Coronary Artery Perforation with Tamponade During Abciximab Infusion in Acute Myocardial Infarction

This case describes a patient with an acute myocardial infarction treated with intravenous abciximab, primary angioplasty, rotablation, and stenting, who had a hydrophilic-coated guidewire-induced vessel perforation, leading to tamponade. Following successful percutaneous pericardiocentesis, leakage was controlled immediately with the delivery of a platinum coil into the perforation, thus avoiding emergency surgical intervention. In selected cases. placement of intracoronary platinum coils to seal guidewire-induced perforations might prevent the need of emergency surgical intervention, especially in highly anticoagulated patients or in those receiving glycoprotein IIb/IIIa blockers.