# Treatment of Coronary Perforation in a Bifurcation: Two‐Stent Strategies With Fenestrated Covered Stents

## TL;DR

This paper discusses treating complex coronary perforations using two-stent strategies with covered stents, focusing on their feasibility and success in real cases.

## Contribution

The novelty lies in presenting and analyzing two-stent strategies with fenestrated covered stents for treating coronary bifurcation perforations.

## Key findings

- Two-stent strategies with covered stents successfully treated complex coronary perforations.
- Fenestrated covered stents are feasible and effective in managing bleeding in coronary bifurcations.
- Proper knowledge and availability of materials are crucial for successful treatment outcomes.

## Abstract

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.