Left main trunk perforation sealed by 90 second perfusion balloon inflation

Coronary perforation is a rare but serious complication of percutaneous coronary intervention. In our case, kissing balloon technique caused the perforation. We took care of balloon diameter and inflation pressure, but we did not consider that the proximal lumen could take elliptical rather than circular shape. Then perforation occurred at the proximal side of the kissing balloon technique. Fortunately, we could achieve hemostasis successfully by 90 seconds perfusion balloon inflation. You must consider not only balloon diameter and inflation pressure but also balloon form as an important safety factor for the kissing balloon technique on the left main trunk.