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Tumscitz et al. Vessel Plus 2019;3:20 Vessel Plus
DOI: 10.20517/2574-1209.2018.71

Case report Open Access

Type III coronary perforation during chronic total
occlusion percutaneous coronary interventions

treated with Cyanoacrylate glue embolization: case
report and review of the technique

Carlo Tumscitz , Valerio Lanzillotti , Lucia Pirani , Anna Maria Di Cesare , Alessandra Scoccia ,
4
3
4
1
2
Francesco Gallo 4
1 Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro, Ferrara 44124, Italy.
2 Cardiology Unit, Ospedale Maggiore di Bologna, Largo Nigrisoli 2, Bologna 40133, Italy.
3 Cardiology Unit, Ospedale del Delta, Via Valle Oppio, 2, Lagosanto Ferrara 44023, Italy.
4 Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro, Ferrara 44124, Italy.
Correspondence to: Dr. Carlo Tumscitz, Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Via Aldo Moro, Ferrara
44124, Italy. E-mail: tumscitz@gmail.com
How to cite this article: Tumscitz C, Lanzillotti V, Pirani L, Di Cesare AM, Scoccia A, Gallo F. Type III coronary perforation during
chronic total occlusion percutaneous coronary interventions treated with Cyanoacrylate glue embolization: case report and
review of the technique. Vessel Plus 2019;3:20. http://dx.doi.org/10.20517/2574-1209.2018.71
Received: First Decision: Revised: Accepted: Published: x Received: 8 Nov 2018 First Decision: 4 Mar 2019 Revised: 1 Apr 2019 Accepted: 22 May 2019 Published: 13 Jun 2019

Science Editor: Copy Editor: Production Editor: C Science Editor: Marouane Boukhris Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract

In recent times the outcome of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) in
dedicated centers has steadily gained high success rate (> 80%) and low rate of coronary complications.
Nevertheless comparing with non-CTO PCI the complications rate is higher, due to the higher lesion and technical
complexity. Among the complications Type III coronary perforations remain the most troublesome events of CTO
PCI and still carry a significant risk of death for the patients. The management of Type III coronary perforations
has been extensively described as a flow chart of interventions and techniques to obtain rapid cessation of the
blood extravasation and sealing of the ruptured vessel. Several techniques have been described to obtain bleeding
cessation also in small vessel (< 2 mm) perforations.In this paper we will describe two cases of CTO PCI with Type
III small vessel coronary perforations treated with percutaneous Cyanoacrylate/(NBCA-MS)-based glue infusion
through a conventional CTO microcatheter. This technique is fast and straightforward and can be applied to any
conventional CTO microcatheter.

Keywords: Type III coronary perforations, coronary chronic total occlusion complication, cyanoacrylate/(NBCA-
MS)-based glue
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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