Incidence, predictors, in-hospital, and late outcomes of coronary artery perforations

Stanković, Goran; Orlić, Dejan; Corvaja, Nicola; Airoldi, Flavio; Chieffo, Alaide; Spanos, Vassilis; Montorfano, Matteo; Carlino, Mauro; Finci, Léo; Sangiorgi, Giuseppe; Colombo, Antonio

doi:10.1016/j.amjcard.2003.09.042

Cited by 103 publications

(78 citation statements)

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“…[1][2][3][4][5][6][7][8] Fasseas, et al reported the incidence to be 0.58% in an analysis of 16,298 procedures carried out between 1990 and 2001.…”

Section: Discussionmentioning

confidence: 99%

“…6) Despite a rapid increase in the incidence of this serious complication in recent years, 1,2,[4][5][6]9) definitive management of coronary perforation has not yet been established. Thus, we reviewed our experiences with coronary perforation during the past 15 years and analyzed the characteristics of the lesion, its management, and clinical outcomes.…”

mentioning

confidence: 99%

“…reports have shown that the incidence of coronary perforation during PCI is 0.2% to 0.6%, [3][4][5][6][7][8] and the use of debulking devices is highly associated with this complication. 6) Despite a rapid increase in the incidence of this serious complication in recent years, 1,2,[4][5][6]9) definitive management of coronary perforation has not yet been established.…”

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confidence: 99%

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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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“…[1][2][3][4][5][6][7][8] Fasseas, et al reported the incidence to be 0.58% in an analysis of 16,298 procedures carried out between 1990 and 2001.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Coronary Perforation During Percutaneous Coronary Intervention Lessons From Our Experiences

et al. 2007

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“…In a retrospective study with PTFE covered stents, Briguari et al [14] reported an improvement in inhospital need for emergency cardiac surgery, cardiac tamponade and in-hospital major adverse cardiac events. However, in a previous single center retrospective study, Stankovic et al [15] reported that covered stents reduced major adverse cardiac events only in Ellis type 3 perforations, but not type 2 perforations.…”

Section: Discussionmentioning

confidence: 99%

Emergency polytetrafluoroethylene-covered stent implantation to treat right coronary artery perforation during percutaneous coronary intervention

Yorgun¹,

Canpolat²,

Aytemir³

et al. 2012

Cardiol J

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“…It is life-saving that the cardiologist performing the invasive procedure is competent and aware of this complication, avoids this complication and has accurate knowledge about how should act when this complication occurs [11]. The choice of large balloon, and high inflation pressure may result in perforation [12,13]. The coronary ruptures which have formed due to invasive procedure interventions are treated according to rupture types-the first groups are those treated by graft stent and the other group is those that are treated conservatively.…”

Section: Introductionmentioning

confidence: 99%

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Yıldız¹,

Karakurt²,

Bitigen³

et al. 2013

Health

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Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20% -0.6%. Its sudden development, the patient's agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women; the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.

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Incidence, predictors, in-hospital, and late outcomes of coronary artery perforations

Cited by 103 publications

References 11 publications

Coronary Perforation During Percutaneous Coronary Intervention Lessons From Our Experiences

Coronary Perforation During Percutaneous Coronary Intervention Lessons From Our Experiences

Emergency polytetrafluoroethylene-covered stent implantation to treat right coronary artery perforation during percutaneous coronary intervention

Fatal complication, rescue therapy; covered stent for coronary artery perforation

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