Surgical Treatment for Ellis Type 3 Coronary Perforation During Percutaneous Catheter Intervention

Totsugawa, Toshinori; Kurabayashi, Masahiko; Yoshitaka, Hidenori; Katayama, Kosuke; Tsushima, Yoshimasa; Ishida, Akira; Chikazawa, Genta; Hiraoka, Arudo

doi:10.1253/circj.cj-11-0773

Cited by 10 publications

(13 citation statements)

References 13 publications

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“…4 The key risk factors which are considered to predispose to the causation of perforation are advanced patient age, female gender and the use of ablative devices. 6 Grade III CP is the most serious form of perforation with a high incidence of mortality rates which may range from 7% to 44% of cases. It is also associated with very high rates of cardiac tamponade which may be as high as 40% and the need for emergency coronary artery bypass grafting (CABG) ranges between 20% and 40%.…”

Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

“…10,11 Though covered stent have been reported to increase thrombogenicity, there are now several reports of the use of covered stents to seal CP with good and lasting results. 5,6 This strategy is more effective if the perforation is located in the proximal or mid-portion of the index vessel and the guidewire is correctly positioned distally in the true lumen. 6 In our case, though we had deployed the stent at a high pressure but the pressure was lower than the burst pressure recommended by the manufacturer and it seemed that oversizing of stent was the cause CP as the index vessel diameter was probably less than 3 mm.…”

Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

“…5,6 This strategy is more effective if the perforation is located in the proximal or mid-portion of the index vessel and the guidewire is correctly positioned distally in the true lumen. 6 In our case, though we had deployed the stent at a high pressure but the pressure was lower than the burst pressure recommended by the manufacturer and it seemed that oversizing of stent was the cause CP as the index vessel diameter was probably less than 3 mm. We performed immediate resuscitation, urgent pericardiocentesis, autologous transfusion and immediate covered stenting with a PTFE stent to close the perforation which eventually proved to be successful in the management of CP in our case.…”

Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

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Successful management of Ellis type III left anterior descending artery perforation following percutaneous coronary intervention by a covered stent: Successfully resolved the dramatic complication

Srinivas

Patra

Ramalingam

et al. 2014

Journal of Cardiovascular Disease Research

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a b s t r a c tCoronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention (PCI). Grade III coronary perforation and rupture invariably results in pericardial effusion and tamponade requiring urgent pericardiocentesis. Advances in coronary intervention have increased the opportunity to treat coronary artery perforation. We are reporting a case of 55 years old hypertensive female who presented with effort angina. Coronary angiogram revealed significant stenosis in the left anterior descending coronary artery. Post PCI, she had Ellis type III coronary perforation and pericardial tamponade and cardiogenic shock. The patient was resuscitated, pericardiocentesis done, autologous blood transfusion given and covered stent deployed.

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Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

Section: Sk Srinivas Et Al / Journal Of Cardiovascular Disease Resmentioning

confidence: 99%

See 1 more Smart Citation

Successful management of Ellis type III left anterior descending artery perforation following percutaneous coronary intervention by a covered stent: Successfully resolved the dramatic complication

Srinivas

Patra

Ramalingam

et al. 2014

Journal of Cardiovascular Disease Research

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“…Previously, Ellis et al (4) described a classification for coronary perforations. According to this classification, Type III is the most fatal type of perforation which usually needs to be treated with emergency surgery or covered stents (1). In this report we describe a case of coronary perforation which occurred during primary PCI of the right coronary artery that was successfully sealed with a hand-made covered stent.…”

Section: Introductionmentioning

confidence: 97%

“…With the advances in device technology, percutaneous coronary intervention (PCI) has become an indispensable option for treatment of coronary artery disease (1). However, the frequency of complications associated with these procedures has also increased.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Coronary Artery Perforation with Hand-Made Covered Stent

Şarlı¹,

Baktır²,

Sağlam³

et al. 2013

Erciyes Med J

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Comparison of mid-term clinical outcomes between on-label and off-label use of rotational atherectomy

et al. 2016

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While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94). The primary endpoint was the incidence of major adverse cardiovascular events (MACE) defined as the composite of ischemia-driven target vessel revascularization (TVR), non-fatal MI, and all-cause death. We also identified 154 patients who underwent RA and follow-up angiography within 1 year, and compared quantitative coronary analysis between the off-label group (n = 96) and on-label group (n = 58). There was no significant difference in late luminal loss between the groups (0.03 ± 0.53 mm in the off-label and -0.05 ± 0.44 mm in the on-label groups, P = 0.57). However, the incidence of MACE was less in the on-label group (3.2 %) as compared to the off-label group (9.0 %) without reaching statistical significance (P = 0.08). In conclusion, mid-term clinical outcomes tended to be worse in the off-label group than in the on-label group. We may have to follow-up the patient who underwent off-label RA more carefully than the patient who underwent on-label RA.

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Surgical Treatment for Ellis Type 3 Coronary Perforation During Percutaneous Catheter Intervention

Cited by 10 publications

References 13 publications

Successful management of Ellis type III left anterior descending artery perforation following percutaneous coronary intervention by a covered stent: Successfully resolved the dramatic complication

Successful management of Ellis type III left anterior descending artery perforation following percutaneous coronary intervention by a covered stent: Successfully resolved the dramatic complication

Successful Treatment of Coronary Artery Perforation with Hand-Made Covered Stent

Comparison of mid-term clinical outcomes between on-label and off-label use of rotational atherectomy

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