{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:00:47Z","timestamp":1771225247807,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T00:00:00Z","timestamp":1755388800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Coronary perforation during percutaneous coronary intervention (PCI) is a rare yet life\u2010threatening complication, often necessitating emergent pericardiocentesis. However, rarely unexpected complications such as vascular injuries may arise, further complicating the clinical course. A 76\u2010year\u2010old lady with progressive angina underwent PCI for significant stenoses in the left anterior descending (LAD) and left circumflex (LCX) artery. The procedure was complicated by a coronary perforation in the mid\u2010LAD, leading to cardiac tamponade. Emergent pericardiocentesis via the subxiphoid approach, guided by echocardiography, drained 300\u2009mL of blood and temporarily stabilized the patient. A covered stent was deployed to seal the LAD perforation, but persistent bleeding suggested a secondary complication. Diagnostic evaluation, including analysis of the pericardial aspirate and repeat angiography, identified an arterial source of bleeding unrelated to the coronary perforation. Exploratory sternotomy revealed an aberrant superior epigastric artery injured during pericardiocentesis. Surgical ligation of the artery resulted in immediate hemodynamic improvement, and the patient was discharged in stable condition after a full recovery. This case highlights a rare vascular complication of pericardiocentesis, specifically an injury to the superior epigastric artery, exacerbated by anatomical variation. Such unreported injuries in the literature underscore the unpredictability of rare vascular complications even in typically safer techniques like the subxiphoid approach. A systematic, stepwise approach\u2014combining imaging guidance, diagnostic evaluations, and prompt surgical intervention\u2014is essential for timely management. Early recognition of vascular injury and swift multidisciplinary collaboration ensured a favorable outcome in this case, emphasizing the importance of vigilance and structured decision\u2010making when complications arise.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70096","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T06:30:41Z","timestamp":1755498641000},"page":"2541-2545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Stitch in Time: Superior Epigastric Artery Injury During Emergency Pericardiocentesis"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9726-3995","authenticated-orcid":false,"given":"Avishkar","family":"Agrawal","sequence":"first","affiliation":[{"name":"Department of Cardiology All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1136-6353","authenticated-orcid":false,"given":"Devesh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Vardhaman Mahavir Medical College and Safdarjung Hospital New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gautam","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiology All India Institute of Medical Sciences New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)62211-8"},{"issue":"2","key":"e_1_2_12_3_1","first-page":"327","article-title":"\u2018Blind\u2019 Pericardiocentesis: A Comparison of Different Puncture Directions","volume":"92","author":"Petri N.","year":"2018","journal-title":"Catheterization and Cardiovascular Interventions"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.18-00188"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/2229-5151.165007"},{"key":"e_1_2_12_6_1","article-title":"Left Internal Mammary Artery Transection: A Rare Complication of Pericardiocentesis","volume":"12","author":"Nair R.","year":"2020","journal-title":"Cureus"},{"issue":"3","key":"e_1_2_12_7_1","first-page":"931","article-title":"Post\u2010Traumatic Internal Mammary Artery Pseudoaneurysm: A Rare Complication of Pericardiocentesis","volume":"9","author":"Mehra S.","year":"2015","journal-title":"Radiology Case Reports"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1014041"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(86)90862-3"},{"issue":"3","key":"e_1_2_12_10_1","first-page":"363","article-title":"Coronary Perforations","volume":"2","author":"Nair P.","year":"2006","journal-title":"EuroIntervention: Journal of EuroPCR in Collaboration With the Working Group on Interventional Cardiology of the European Society of Cardiology"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13089-022-00259-5"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70096","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70096","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T06:01:04Z","timestamp":1771221664000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,17]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/ccd.70096"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70096","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,17]]},"assertion":[{"value":"2025-06-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}