eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-01-27 9 4 232 235 10.12691/ajmcr-9-4-7 AJMCR2021947 article Kitigon Vichairuangthum neozz15@hotmail.com 1 Division of Cardiology, Department of Medicine, Suranaree University of Technology Hospital, Nakhon Ratchasima, Thailand Coronary artery perforation is a rare but fatal complication of percutaneous coronary intervention. Cardiac tamponade constitutes the most severe clinical consequence. If not properly and promptly treated, it is burdened by a high mortality rate. This article report the case of an intra-stent coronary perforation after simple revascularization, followed by an immediate impairment of hemodynamic compensation, due to significant pericardial effusion and sub-sequent cardiac tamponade. While prompt surgical intervention may be lifesaving, expertise in the use of stent graft may provide a valuable rescue option for this serious complication. Interventional cardiologists should be able to recognize and know available treatment options of this serious complication. http://pubs.sciepub.com/ajmcr/9/4/7/ajmcr-9-4-7.pdf coronary perforation percutaneous coronary intervention prolong balloon inflation stent graft