{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:09Z","timestamp":1753876209995,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T00:00:00Z","timestamp":1621123200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background\u2003<\/jats:title>\n                  <jats:p>Despite improvement in available tools and techniques, procedural complications like coronary perforation can occur during percutaneous coronary intervention (PCI). Severe proximal coronary perforations are usually caused by balloon and vessel size mismatch but can also occur with appropriately sized balloons or stents if the coronary vessel has very eccentric calcification or if there is negative remodelling of the vessel.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary\u2003<\/jats:title>\n                  <jats:p>A 74-year-old man with a history of type II diabetes mellitus, hypertension, and chronic coronary syndrome (previous PCI 10\u2009years before) presented with unstable angina of 2\u2009weeks of duration. Coronary angiography revealed a patent stent in left anterior descending artery, significant disease in left circumflex artery and diffuse calcified lesion in dominant right coronary artery (RCA). During angioplasty of RCA, the patient developed severe Ellis grade III perforation, which was successfully managed with modified double guiding catheter \u2018Ping Pong\u2019 technique. In this technique, the already engaged 7 French (F) Amplatz Left 1 guide catheter was used to deliver the bulky covered stent in highly tortuous and calcified RCA while a second 6F guide catheter (Judkin Right) introduced through contralateral femoral access was used for introducing the balloon, which initially sealed the perforation and subsequently acted as a distal anchor to provide strong support to deliver the covered stent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>In a case of severe coronary perforation, modified Ping Pong technique using a small-sized second guide catheter complimentary to the first guide catheter, can be used to deploy bulky covered stent.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab173","type":"journal-article","created":{"date-parts":[[2021,5,16]],"date-time":"2021-05-16T18:58:43Z","timestamp":1621191523000},"source":"Crossref","is-referenced-by-count":4,"title":["Modified double guiding catheter \u2018Ping Pong\u2019 technique to treat large coronary perforation: a case report"],"prefix":"10.1093","volume":"5","author":[{"given":"Himanshu","family":"Gupta","sequence":"first","affiliation":[{"name":"Advance Cardiac Center, Sector 12, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, Indi a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-0798","authenticated-orcid":false,"given":"Navjyot","family":"Kaur","sequence":"additional","affiliation":[{"name":"Advance Cardiac Center, Sector 12, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, Indi a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yashpaul","family":"Sharma","sequence":"additional","affiliation":[{"name":"Advance Cardiac Center, Sector 12, Post Graduate Institute of Medical Education & Research, Chandigarh 160012, Indi a"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soo Teik","family":"Lim","sequence":"additional","affiliation":[{"name":"5 Hospital Drive, Level 2 Pharmacy, National Heart Centre Singapore 169609"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,16]]},"reference":[{"key":"2021070816564088200_ytab173-B1","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.cjca.2011.04.014","article-title":"Coronary artery perforation during percutaneous coronary intervention: a systematic review and meta-analysis","volume":"27","author":"Shimony","year":"2011","journal-title":"Can J Cardiol"},{"key":"2021070816564088200_ytab173-B2","doi-asserted-by":"crossref","first-page":"e003449","DOI":"10.1161\/CIRCINTERVENTIONS.115.003449","article-title":"Incidence, determinants and outcomes of coronary perforation during percutaneous coronary intervention in the United Kingdom between 2006 and 2013. An analysis of 527121 cases from the British Cardiovascular Intervention Society Database","volume":"9","author":"Kinnaird","year":"2016","journal-title":"Circ Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1002\/ccd.1065","article-title":"Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb\/IIIa blockade: an algorithm for percutaneous management","volume":"52","author":"Dippel","year":"2001","journal-title":"Catheter Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B4","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1111\/j.1540-8183.2009.00469.x","article-title":"Coronary artery perforations in the contemporary interventional era","volume":"22","author":"Kiernan","year":"2009","journal-title":"J Interv Cardiol"},{"key":"2021070816564088200_ytab173-B5","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.jcin.2018.05.052","article-title":"A practical approach to the management of complications during percutaneous coronary intervention","volume":"11","author":"Giannini","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B6","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1161\/01.CIR.90.6.2725","article-title":"Increased coronary perforation in the new device era. Incidence, classification, management and outcome","volume":"90","author":"Ellis","year":"1994","journal-title":"Circulation"},{"key":"2021070816564088200_ytab173-B7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jcin.2010.08.026","article-title":"Incidence, predictors, management, immediate and long-term outcomes following grade III coronary perforation","volume":"4","author":"Al-Lamee","year":"2011","journal-title":"JACC Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B8","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.jcin.2010.09.021","article-title":"Coronary perforation","volume":"4","author":"Eeckhout","year":"2011","journal-title":"JACC Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.ijcard.2015.08.138","article-title":"Treatment and outcome of coronary artery perforations using a dual guiding catheter technique","volume":"201","author":"Rother","year":"2015","journal-title":"Int J Cardiol"},{"key":"2021070816564088200_ytab173-B10","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1002\/ccd.22331","article-title":"Dual catheter technique for the treatment of severe coronary artery perforations","volume":"75","author":"Ben-Gal","year":"2010","journal-title":"Catheter Cardiovasc Interv"},{"key":"2021070816564088200_ytab173-B11","first-page":"348","article-title":"Dual-catheter covered stenting: a novel approach to the treatment of coronary artery perforations","volume":"15","author":"Silver","year":"2003","journal-title":"J Invasive Cardiol"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/5\/ytab173\/37940172\/ytab173.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/5\/ytab173\/37940172\/ytab173.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:56:44Z","timestamp":1625792204000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab173\/6276526"}},"subtitle":[],"editor":[{"given":"Julien","family":"Adjedj","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mariama","family":"Akodad","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Christoph","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"and Felice","family":"Gragnano","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Gemina","family":"Doolub","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nida","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,1]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab173","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2021,5,1]]},"published":{"date-parts":[[2021,5,1]]},"article-number":"ytab173"}}