Treatment of Coronary Perforation in a Bifurcation: Two-Stent Strategies With Fenestrated Covered Stents.

Coronary perforations are a dreaded complication for any interventional cardiologist. The treatment of this complication is exceptionally difficult when it occurs in a coronary bifurcation. While a conservative approach or a balloon occlusion might be sufficient in some cases, additional treatment is sometimes necessary. Here, we present two cases, where complex two-stent strategies with covered stents were necessary to successfully treat the bleeding. The aim is to discuss the feasibility of this method, while also analyzing published cases where fenestration of a covered coronary stent was successfully performed. The commonly used material is discussed, including its capabilities and limitations. With the proper knowledge about the different treatment options and the required material readily available, this difficult complication can be successfully treated in the catheterization laboratory.