CTICasesCoronary Artery Perforation
Imaging findings
Non-contrast chest CT performed hours after coronary catheterization shows high-attenuation contrast material extravasating and pooling within the mediastinal fat and pericardial space, closely outlining the course of the coronary arteries, consistent with coronary artery dissection and perforation.
Key takeaways
Coronary artery perforation is a rare but serious complication of percutaneous coronary intervention (PCI). It can lead to contrast extravasation into the pericardium, resulting in hemopericardium and cardiac tamponade. On post-procedure non-contrast CT, the extravasated contrast remains visible as hyperdense fluid in the pericardial space or mediastinum.
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