Devices for Chronic Occlusion

Kirvaitis, Romas J.; Reese, Amber; Waters, Karen; Kelly, Lisa M.; Heuser, Richard R.

doi:10.1111/j.1541-9215.2006.04808.x

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…3,12) The recently developed stiff guidewires have increased the success rate for crossing chronic total occlusion lesions. 13) As a result, the number of PCI conducted for difficult and fragile lesions, which were previously considered to be unsuitable for PCI, has increased. This alteration in the type of lesion targeted by PCI may be associated with the rapid increase in the incidence of coronary perfusion over the time period of this study.…”

Section: Discussionmentioning

confidence: 99%

Coronary Perforation During Percutaneous Coronary Intervention Lessons From Our Experiences

et al. 2007

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SUMMARYCoronary perforation is an undesirable complication during percutaneous coronary intervention (PCI). We reviewed the cases of overt coronary perforation in our institute and analyzed their clinical backgrounds, the characteristics of the target lesion, management, and clinical outcomes. Between 1991 and 2005, we experienced 12 cases (0.35%) of coronary perforation in a total of 3415 PCI procedures. The perforation occurred during the use of debulking devices in 3 cases, immediately after stenting in 2, immediately after postdilatation of the stent in 2, and during wiring in 3 cases. Restoration was attempted by long inflation of a balloon in 7 cases, implantation of a covered stent graft in 1, and emergency surgical repair in 1 case. Subsequent cardiac tamponade occurred in 3 patients who required pericardiocentesis, and 1 patient died due to congestive heart failure. Administration of protamine was effective in stopping the bleeding in 6 patients, whereas continuation of antiplatelet therapy resulted in no overt rebleeding. Coronary perforation during PCI is a rare complication but is associated with significant morbidity and mortality. Intravenous administration of protamine is effective when it is used in conjunction with nonsurgical devices for initial management of perforation. (Int Heart J 2007; 48: 1-9)

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Section: Discussionmentioning

confidence: 99%