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.

coronary perforation, percutaneous coronary intervention, prolong balloon inflation, stent graft