Images and Case Reports in Interventional Cardiology Delayed Perforation of Coronary Artery after Percutaneous Coronary Intervention of Left Main Bifurcation Lesion Using Two Stents

Coronary artery perforation during percutaneous coronaryintervention (PCI) has been reported repeatedly. How-ever, delayed perforation several months after PCI, which may cause potentially serious complications, has not been well recognized.1,2 Here we report a case of delayed coronary artery perforation 4 months after PCI of the left main bifurcation lesion. A 69-year-old man with intermittent syncope underwent follow-up diagnostic coronary angiography. He was under maintenance hemodialysis for 9 years and had multiple risk factors, including hypertension, dyslipidemia, and diabetes. Four months earlier, he suffered from acute myocardial infarction with ST-elevation in multiple leads from V1 to V4, and underwent emergent percutaneous coronary intervention for critical left main (LM) bifurcation disease, involving 90% ostial stenosis of both left anterior descending (LAD) arter