{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:32Z","timestamp":1753890632912,"version":"3.41.2"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pericardiocentesis is both therapeutic and diagnostic invasive procedure, guided by echocardiography and\/or angiography. It can be done using subcostal or apical approach. One of the major complications of pericardiocentesis is coronary artery laceration with an incidence of less than 1%. Diagnosis of such lacerations is often made by invasive coronary angiography or urgent thoracotomy. Computed tomography angiography is used to determine the extent of bleeding and hemopericardium, but its potential for detailed evaluation of bleeding site is somewhat underestimated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present a rare case of distal obtuse marginal (OM) artery perforation resulting from apical pericardiocentesis that was diagnosed with CT angiography (CTA) further treated with coronary guidewire particle embolization. A 49-year-old male patient who had undergone ascending aorta and aortic arch reconstruction after an aortic dissection Type A was evaluated with echocardiography before being discharged from our hospital. A loculated pericardial effusion was identified, necessitating pericardiocentesis. The clinical course was further complicated by hemopericardium due to coronary laceration. The hemorrhage was managed with coronary guidewire segment embolization which led to immediate improvement in hemodynamic status. The patient was discharged seven days after intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Coronary artery perforation is a rare, albeit life-threatening complication of pericardiocentesis that requires urgent surgical or percutaneous intervention. CTA can provide important diagnostic information on perforation location and help in deciding whether embolization or open-heart surgery is needed to address ongoing bleeding.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1535797","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T07:09:45Z","timestamp":1741676985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Computerized tomography angiography in diagnosing an obtuse marginal branch perforation after pericardiocentesis: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"A.","family":"Ostojic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z.","family":"Antonic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Ilic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.5847\/wjem.j.1920-8642.2021.03.001","article-title":"What is the ideal approach for emergent pericardiocentesis using point-of-care ultrasound guidance?","volume":"12","author":"Stolz","year":"2021","journal-title":"World J Emerg Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1007\/s11886-024-02134-2","article-title":"Pericardiocentesis: history, current practice, and future directions","volume":"26","author":"Kalluri","year":"2024","journal-title":"Curr Cardiol Rep"},{"key":"B3","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1007\/s40719-015-0032-9","article-title":"Operative management of cardiac injuries: diagnosis, technique, and postoperative complications","volume":"1","author":"Ingraham","year":"2015","journal-title":"Curr Trauma Rep"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1093\/eurheartj\/ehs372","article-title":"Management of pericardial effusion","volume":"34","author":"Imazio","year":"2013","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1177\/1753944718792413","article-title":"Computed tomography-guided pericardiocentesis: a systematic review concerning contemporary evidence and future perspectives","volume":"12","author":"Vilela","year":"2018","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12872-021-01875-0","article-title":"Coronary artery perforation secondary to lifesaving pericardiocentesis for cardiac tamponade: a case report","volume":"21","author":"Kanda","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"B7","doi-asserted-by":"publisher","first-page":"100409","DOI":"10.1016\/j.jscai.2022.100409","article-title":"Coronary artery perforation: a rare serious complication of pericardiocentesis","volume":"1","author":"Harfouch","year":"2022","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"key":"B8","doi-asserted-by":"publisher","first-page":"ytab400","DOI":"10.1093\/ehjcr\/ytab400","article-title":"Looped wire advancement-not always safe! fat-not so useless! a case series","volume":"5","author":"Gawalkar","year":"2021","journal-title":"Eur Heart J Case Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s12928-014-0299-8","article-title":"Sealing of a dual feeding coronary artery perforation with homemade spring guidewire","volume":"30","author":"Hartono","year":"2015","journal-title":"Cardiovasc Interv Ther"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1535797\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T07:09:49Z","timestamp":1741676989000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1535797\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,11]]},"references-count":9,"alternative-id":["10.3389\/fcvm.2025.1535797"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1535797","relation":{},"ISSN":["2297-055X"],"issn-type":[{"type":"electronic","value":"2297-055X"}],"subject":[],"published":{"date-parts":[[2025,3,11]]},"article-number":"1535797"}}