Coronary perforation managed with covered stent

A72-year-old female with history of hypertension and dyslipidemia, presented with recurrent typical chest pain. She was found to have significant coronary artery disease in the left anterior descending (LAD) coronary artery and the right coronary artery (RCA). Angioplasty of calcified LAD lesion resulted in coronary perforation measuring about 3–4 mm in the vessel wall (Fig. 1A) with hemodynamic instability requiring pericardiocentesis for cardiac tamponade. The perforation was successfully sealed with deployment of covered stent (Fig. 1B). The RCA lesion was stented with no complication.