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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\u2010stent 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.<\/jats:p>","DOI":"10.1002\/ccd.70450","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T09:31:55Z","timestamp":1767000715000},"page":"1080-1087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Coronary Perforation in a Bifurcation: Two\u2010Stent Strategies With Fenestrated Covered Stents"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2015-968X","authenticated-orcid":false,"given":"Jakob U.","family":"Lindner","sequence":"first","affiliation":[{"name":"Department of Internal Medicine\/Cardiology Heart Center Leipzig at Leipzig University and Leipzig Heart Science Leipzig Germany"},{"name":"Department of Internal Medicine\/Cardiology German Army Hospital Ulm Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"P\u00f6ss","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology Heart Center Leipzig at Leipzig University and Leipzig Heart Science Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-998X","authenticated-orcid":false,"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology Heart Center Leipzig at Leipzig University and Leipzig Heart Science Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry S.","family":"Sulimov","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology Heart Center Leipzig at Leipzig University and Leipzig Heart Science Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-014-0254-8"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2017.03.006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.6.2725"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.115.003449"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28933"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.02.041"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2012.11.007"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22331"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytad415"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccas.2025.103382"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.02.033"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.07.048"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-021-00760-z"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28114"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytac410"},{"key":"e_1_2_7_17_1","unstructured":"Biotronik AG PK Papyrus Brochure. 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