{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:09Z","timestamp":1753876269788,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary artery perforation (CAP), though rare, is a serious complication of percutaneous coronary intervention (PCI) that demands prompt, tailored management. Swift recognition and intervention are essential. Typically, a covered stent is used to seal the perforation and restore vessel integrity. However, if unavailable, a homemade covered stent can be crafted and deployed. The choice of treatment depends on bleeding severity, patient stability, and available resources.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 70-year-old male with a history of diabetes and hypertension presented with severe chest pain persisting for 7\u20138\u2005h, radiating to the left arm and jaw, accompanied by diaphoresis and nausea. His baseline electrocardiogram revealed an extensive anterior wall myocardial infarction, prompting immediate transfer to the catheterization laboratory for primary PCI. During the procedure, an unfortunate complication of CAP leading to cardiac tamponade was successfully managed by pericardiocentesis. With the unavailability of commercial covered stents, an improvised covered stent was fashioned and deployed, effectively sealing the perforation despite ongoing administration of glycoprotein IIb\/IIIa inhibitors and heparin which was initiated following acute stent thrombosis. The patient's haemodynamic status stabilized during hospitalization, and he was discharged in a stable condition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our case is a pioneering instance of using a homemade stent with glycoprotein IIb\/IIIa inhibitors and heparin in a STEMI patient with CAP. This novel approach was successful, demonstrating its feasibility and safety. Our experience suggests that improvised stenting techniques could be a viable option in complex coronary interventions, especially when commercial alternatives are unavailable. Further validation may broaden treatment options and improve outcomes in interventional cardiology.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf046","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T10:47:10Z","timestamp":1738752430000},"source":"Crossref","is-referenced-by-count":0,"title":["Homemade stent shields: fortifying against coronary perforation in STEMI patients amidst intensive glycoprotein IIb\/IIIa inhibitors\u2014a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3145-2280","authenticated-orcid":false,"given":"Muhammad Imran","family":"Hanif","sequence":"first","affiliation":[{"name":"Department of Cardiology, Gulab Devi Chest Hospital , Ferozepur Road, Lahore 54000 ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minahil","family":"Tariq Sheikh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gulab Devi Chest Hospital , Ferozepur Road, Lahore 54000 ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"2025021110362415000_ytaf046-B1","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1016\/j.amjcard.2019.07.021","article-title":"Prevalence and predictors of coronary artery perforation during percutaneous coronary interventions (from the ORPKI National Registry in Poland)","volume":"124","author":"Rakowski","year":"2019","journal-title":"Am J Cardiol"},{"key":"2025021110362415000_ytaf046-B2","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/j.ijcard.2008.04.083","article-title":"Covered stents: a review","volume":"130","author":"Jamshidi","year":"2008","journal-title":"Int J Cardiol"},{"key":"2025021110362415000_ytaf046-B3","doi-asserted-by":"crossref","first-page":"6661763","DOI":"10.1155\/2021\/6661763","article-title":"Clinical outcomes of self-made polyurethane-covered stent implantation for the treatment of coronary artery perforations","volume":"2021","author":"Song","year":"2021","journal-title":"J Interv Cardiol"},{"key":"2025021110362415000_ytaf046-B4","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.jcin.2016.11.059","article-title":"Management of no-reflow phenomenon in the catheterization laboratory","volume":"10","author":"Rezkalla","year":"2017","journal-title":"JACC Cardiovasc Interv"},{"key":"2025021110362415000_ytaf046-B5","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ccl.2020.07.001","article-title":"State of the art: no-reflow phenomenon","volume":"38","author":"Caiazzo","year":"2020","journal-title":"Cardiol Clin"},{"key":"2025021110362415000_ytaf046-B6","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/joic.12347","article-title":"Clinical outcomes following covered stent for the treatment of coronary artery perforation","volume":"29","author":"Lee","year":"2016","journal-title":"J Interv Cardiol"},{"author":"Kilic","key":"2025021110362415000_ytaf046-B7"},{"key":"2025021110362415000_ytaf046-B8","doi-asserted-by":"crossref","first-page":"O141","DOI":"10.1186\/1749-8090-8-S1-O141","article-title":"New polyurethane prostheses for substitution of cardiac valve disease and remodeling of the right ventricle in congenital heart malformations","volume":"8","author":"Maluf","year":"2013","journal-title":"J Cardiothorac Surg"},{"key":"2025021110362415000_ytaf046-B9","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1002\/ccd.10620","article-title":"Society of cardiac angiography and interventions: suggested management of the no-reflow phenomenon in the cardiac catheterization laboratory","volume":"60","author":"Klein","year":"2003","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025021110362415000_ytaf046-B10","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1016\/j.jcin.2015.04.031","article-title":"Impact of glycoprotein IIb\/IIIa inhibition in contemporary percutaneous coronary intervention for acute coronary syndromes: insights from the national cardiovascular data registry","volume":"8","author":"Safley","year":"2015","journal-title":"JACC Cardiovasc Interv"},{"key":"2025021110362415000_ytaf046-B11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/ehjcvp\/pvu008","article-title":"Risk of thrombocytopenia with glycoprotein IIb\/IIIa inhibitors across drugs and patient populations: a meta-analysis of 29 large placebo-controlled randomized trials","volume":"1","author":"Wessler","year":"2015","journal-title":"Eur Heart J Cardiovasc Pharmacother"}],"container-title":["European Heart Journal - 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