Embolization of a septal branch perforation using subcutaneous fat during a percutaneous coronary intervention of chronic total occlusion by retrograde approach.

We describe a case of septal branch perforation during percutaneous coronary intervention of a right coronary artery chronic total occlusion. The septal branch perforation was treated with administration of autologous fat into the septal branch with significant reduction of extravasation. This treatment was followed by prolonged balloon inflation at the exit point of the septal branch in the donor artery which definitively sealed the perforation.