TCT-126 Thrombin Clot Injection for the Treatment of Coronary Wire Perforation

Yuta, Imai; Tarutani, Yasuhiro; Hosaka, Fumitaka; Shinji, Kazuya; Yoshino, Tomohide; Teramura, Masanori; Kakuno, Motohiko

doi:10.1016/j.jacc.2014.07.157

Cited by 2 publications

(2 citation statements)

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“…In the area of coronary intervention, there are some methods to stop a coronary artery perforation, including peripheral artery perforation cases, such as ballooning, fat tissue embolization, and coil embolization . Moreover, there is a report regarding the efficacy of thrombin clot injection . The success of hemostasis with thrombin clot injection was observed in all patients, and the thrombin clot injection might be an effective method to stop artery perforation if conventional methods fail.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method

Tokuda

Hirano

Yamawaki

et al. 2017

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method

Tokuda

Hirano

Yamawaki

et al. 2017

Cathet Cardio Intervent

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“…If unable to differentiate based on these parameters, a fourth investigator (PMik) would select between the papers with the article providing most data regarding our secondary objectives being selected for inclusion. Sixty-seven papers were included in the final statistical analysis4–7 10–72 (figure 1). Efforts to exclude data pertaining to CTO procedures within a larger dataset were made by the authors.…”

Section: Methodsmentioning

confidence: 99%

Coronary perforation incidence, outcomes and temporal trends (COPIT): a systematic review and meta-analysis

et al. 2022

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Coronary perforation is a potentially life-threatening complication of percutaneous coronary intervention (PCI). We studied incidence, outcomes and temporal trends following PCI-related coronary artery perforation (CAP).MethodsProspective systematic review and meta-analysis including meta-regression using MEDLINE and EMBASE to November 2020. We included ‘all-comer’ PCI cohorts including large PCI registries and randomised controlled trials and excluding registries or trials limited to PCI in high-risk populations such as chronic total occlusion PCI or cohorts treated only with atheroablative devices. Regression analysis and corresponding correlation coefficients were performed comparing perforation incidence, mortality rate, tamponade rate and the rate of Ellis III perforations against the midpoint (year) of data collection to determine if a significant temporal relationship was present.Results3997 studies were screened for inclusion. 67 studies met eligibility criteria with a total of 5 568 191 PCIs included over a 38-year period (1982–2020). The overall pooled incidence of perforation was 0.39% (95% CI 0.34% to 0.45%) and remained similar throughout the study period. Around 1 in 5 coronary perforations led to tamponade (21.1%). Ellis III perforations are increasing in frequency and account for 43% of all perforations. Perforation mortality has trended lower over the years (7.5%; 95% CI 6.7% to 8.4%). Perforation risk factors derived using meta-regression were female sex, hypertension, chronic kidney disease and previous coronary bypass grafting. Coronary perforation was most frequently caused by distal wire exit (37%) followed by balloon dilation catheters (28%). Covered stents were used to treat 25% of perforations, with emergency cardiac surgery needed in 17%.ConclusionCoronary perforation complicates approximately 1 in 250 PCIs. Ellis III perforations are increasing in incidence although it is unclear whether this is due to reporting bias. Despite this, the overall perforation mortality rate (7.5%) has trended lower in recent years. Limitations of our findings include bias that may be introduced through analysis of multidesign studies and registries without pre-specified standardised perforation reporting CMore research into coronary perforation management including the optimal use of covered stents seems warranted.PROSPERO registration numberCRD42020207881.

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TCT-126 Thrombin Clot Injection for the Treatment of Coronary Wire Perforation

Cited by 2 publications

References 0 publications

Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method

Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method

Coronary perforation incidence, outcomes and temporal trends (COPIT): a systematic review and meta-analysis

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