# Case report: Uncontrollable coronary artery perforation caused by severe stenosis proximal to loopy vessels

## TL;DR

This case report describes a rare and severe coronary artery perforation that required emergency surgery due to complex vessel anatomy.

## Contribution

The novelty lies in presenting a unique clinical scenario where standard interventions failed, necessitating surgical intervention.

## Key findings

- A coronary artery perforation occurred due to radial guidewire cutting in a tortuous lesion.
- Emergency surgical suturing was required as conventional methods were ineffective.
- The case highlights challenges in managing perforations in complex coronary anatomy.

## Abstract

Coronary artery perforation(CAP) is a rare but potentially life-threatening event. Typically, such complications can be effectively managed with appropriately placed covered stents or embolization. However, in special cases, these methods may prove less effective. Here, we present a case of CAP requiring emergency surgical suturing: a perforation caused by radial cutting of the guidewire in a tortuous coronary lesion, accompanied by rapid opening of distal side branches in a narrowed vessel.