Coronary endarterectomy and stent removal after iatrogenic perforation.

Coronary perforation is a rare complication of percutaneous coronary intervention. We report a case of type 3 coronary artery perforation after stenting of the left anterior descending coronary artery. Pericardiocentesis was required to treat cardiac tamponade and prolonged balloon inflation did not stop the bleeding. Urgent surgical intervention with coronary endarterectomy, removal of the stent, and bypass grafting using the left internal mammary artery to the left anterior descending artery was successful. Complete removal of stent with endarterectomy is a feasible option for perforation as a complication of coronary stenting.