ReviewJournal of the Society for Cardiovascular Angiography & Interventions
Bail-Out Techniques in Percutaneous Intervention for Ellis Grade III Coronary Perforation in Left Main Distal Bifurcation Lesions.
Review in Journal of the Society for Cardiovascular Angiography & Interventions. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- IVUS-Guided Orbital Atherectomy and Intravascular Lithotripsy for Severely Calcified Coronary Lesions.JACC. Case reports · 2026Article
- Left Main Stem Perforation: Management Strategies in a Potentially Catastrophic Event.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Defusing a ticking time bomb: percutaneous intervention for a giant coronary pseudoaneurysm - a case report.BMC cardiovascular disorders · 2026Article
- Article
- Bench Testing Analysis of Perforation Management in the Setting of Bifurcation Coronary Intervention.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- A practical approach to the management of percutaneous coronary intervention complications.Frontiers in cardiovascular medicine · 2026Review
- The First-in-Man Technique of Drug Eluting and Perfusion Therapy for Left Main Coronary Artery Disease.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025Article
- Complex Treatment of a Coronary Bifurcation Perforation With a Dual-Covered Stent Strategy.JACC. Case reports · 2025Article
- Catastrophic Left Main Coronary Artery Perforation During Complex Percutaneous Coronary Intervention: Successful Multidisciplinary Management.JACC. Case reports · 2025Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The left main (LM) coronary artery stenosis is associated with high morbidity and mortality and has traditionally been treated with coronary artery bypass grafting. However, in recent years, advancements in device technology and adjunctive pharmacotherapy have led to the widespread use of percutaneous coronary intervention (PCI) as a treatment for unprotected LM lesions. Despite this, LM lesions are often complex, involving distal bifurcation and heavy calcification, which increases the risk of coronary perforation (CP) during PCI. In addition, the use of rotational or orbital atherectomy in severely calcified LM bifurcation lesions carries a higher risk of complications and in-hospital mortality than that in non-LM lesions. CP is a rare but potentially fatal complication of PCI, particularly in cases of Ellis grade III (CP-G3), with a high rate of cardiac tamponade and mortality. The management of CP-G3 in LM distal bifurcation lesions is challenging and requires specialized techniques. This article presents a flowchart of bail-out strategies for CP-G3 in LM distal bifurcation lesions and provides detailed procedures for each technique. Furthermore, we highlight the challenges and limitations of each technique, requiring careful management when CP-G3 occurs in LM distal bifurcation lesions.
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