Coronary perforation – Cardiology MCQ

Pericardial or myocardial blushing is Grade — in Ellis classification of coronary perforation during percutaneous coronary intervention (PCI):

  1. Grade I
  2. Grade II
  3. Grade III
  4. Grade IV

Correct Answer: 2. Grade II

Ellis classification is based on angiographic appearance of the perforation.1

Grade I: Extraluminal crater without extravasation
Grade II: Pericardial or myocardial blushing
Grade III: Perforations of one or more millimeter diameter with contrast streaming or spilling


  1. Ellis SG et al. Increased coronary perforation in the new device era. Incidence, classification, management, and outcome. Circulation. 1994 Dec;90(6):2725-30.