Coronary artery perforation is an infrequent (0.7 %) , but potentially life-threatening, complication of percutaneous coronary intervention (PCI). The incidence of perforation is higher in complex PCI, such as chronic total occlusion (CTO) PCI . While the Ellis classification can be used to describe the severity of perforation , the perforation location (large vessel, distal vessel, septal or epicardial collaterals) has important implications for management . Large-vessel perforations are typically treated with covered stents, whereas distal-vessel or collateral-vessel perforations are usually treated with fat/coil embolization , although covered stents can also be used to seal the origin of the perforated vessel. Two covered stents are currently available in the US for the treatment of coronary perforations: the Graftmaster (Abbott Vascular, Santa Clara, CA), and the PK Papyrus (Biotronik AG, Bülach, Switzerland). PK Papyrus became available in 2019 and has become the preferred covered stent in many cardiac catheterization laboratories due to lower profile and easier delivery .