Complications of chronic total occlusion percutaneous coronary intervention: Subepicardial hematoma

Punag Divanji, Kendrick Shunk

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


A 67-year-old man with coronary artery disease and previous coronary underwent successful Guideliner reverse CART percutaneous coronary intervention of a chronic total occlusion of the right coronary artery. He later developed evidence of myocardial ischemia, and imaging, including angiogram, echocardiogram, and cardiac computed tomography revealing active dye extravasation from the previously normal RV marginal branches, in addition to a large subepicardial hematoma. Despite these dramatic findings, the patient remained hemodynamically stable and pain-free, with resolving ECG changes. Thus, with close clinical observation, the patient did not undergo pericardiocentesis or other invasive procedures, and was discharged home safely. This review evaluates the complications of CTO-PCI, with a focus on subepicardial hematomas, discussing diagnosis and management of this highly morbid complication.

Original languageEnglish (US)
Pages (from-to)553-557
Number of pages5
JournalCardiovascular Revascularization Medicine
Issue number5
StatePublished - Jul 2018


  • Chronic total occlusion
  • Complication
  • Hematoma
  • Hemodynamics
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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