{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:07:42Z","timestamp":1790140062359,"version":"4.0.1"},"reference-count":6,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Coronary perforation is a rare but potentially life\u2010threatening complication of percutaneous coronary intervention. We report a case of delayed hemorrhagic pericardial effusion caused by an initially occult distal wire\u2010related perforation after successful covered\u2010stent sealing of a proximal Ellis type III rupture. A 67\u2010year\u2010old man underwent PCI for a severely calcified mid\u2010right coronary artery lesion complicated by proximal Ellis type III perforation after high\u2010pressure post\u2010dilatation. The perforation was immediately sealed with a covered\u2010stent, and early echocardiographic follow\u2010up showed only minimal stable pericardial effusion. Seven days later, the patient re\u2010presented with chest pain and dyspnea. Transthoracic echocardiography demonstrated a large pericardial effusion, and repeat angiography revealed distal contrast extravasation without leakage from the covered\u2010stent segment. Balloon occlusion was initially performed in the posterior descending artery to localize the bleeding source; persistent extravasation led to reassessment and localization of the perforation to the posterolateral branch. Prolonged balloon occlusion of the posterolateral branch reduced but did not eliminate extravasation. Autologous fat embolization using a Corsair Pro microcatheter achieved complete hemostasis. This case highlights a dual\u2010site perforation mechanism in which a clinically dominant proximal rupture may mask a concomitant distal wire\u2010related injury, emphasizing the need for systematic distal vessel reassessment after complicated PCI.<\/jats:p>","DOI":"10.1002\/ccd.70902","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:55:37Z","timestamp":1790139337000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Distal Coronary Perforation After Successful Covered\u2010Stent Sealing of a Proximal Ellis Type III Rupture: A Dual\u2010Site Mechanism"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8453-205X","authenticated-orcid":false,"given":"Rauf","family":"Avc\u0131","sequence":"first","affiliation":[{"name":"Department of Cardiology Antalya Training and Research Hospital Antalya T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7374-3755","authenticated-orcid":false,"given":"Onur Umut","family":"Erdo\u011fdu","sequence":"additional","affiliation":[{"name":"Department of Cardiology Antalya Training and Research Hospital Antalya T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9768-918X","authenticated-orcid":false,"given":"G\u00f6ksel","family":"\u00c7a\u011f\u0131rc\u0131","sequence":"additional","affiliation":[{"name":"Department of Cardiology Antalya Training and Research Hospital Antalya T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.6.2725"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25121"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30861"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2012.42.5.352"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26542"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.14744\/AnatolJCardiol.2016.7445"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70902","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70902","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70902","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:55:38Z","timestamp":1790139338000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":6,"alternative-id":["10.1002\/ccd.70902"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70902","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]},"assertion":[{"value":"2026-06-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70902"}}