A unique complication of the retrograde approach in angioplasty for chronic total occlusion of the coronary artery.

The retrograde approach for chronic total occlusion of coronary arteries is a new treatment strategy, although its attendant complications have not yet been fully appreciated. We report a case of isolated left ventricular cardiac tamponade caused by guidewire-induced perforation of the septal branch during the retrograde approach, which was subsequently diagnosed by computed tomography (CT) and which required surgical drainage. Guidewire-induced perforation of the septal branch was successfully treated by autologous subcutaneous tissue embolization of the perforated coronary artery. This is the first case of its kind to date. Copyright 2008 Wiley-Liss, Inc.