Coronary artery perforation in patients undergoing percutaneous coronary intervention: a single-centre report.
The present study reports the incidence, management and clinical outcome of coronary perforations in 5 of 2991 patients (0.1%) undergoing percutaneous coronary intervention, with non-debulking (percutaneous transluminal coronary angioplasty and stent) techniques. There was 1 type I, 1 type II and 3 type III perforations. One perforation was guidewire related, 2 perforations occurred after stent deployment and two occurred during stent-post dilatation with balloons. Restoration was obtained by prolong balloon inflation in three cases. Subsequent cardiac tamponade occurred in 2 patients, requiring pericardiocentesis. One patient died in the cath lab. due to electromechanical dissociation. At follow-up, 3 out of 4 patients were asymptomatic and one had bypass surgery for restenosis. Treatment of coronary perforation requires rapid detection, angiographic classification, and immediate occlusion of perforation site, pericardiocentesis, haemodynamic support and reversal of heparin anticoagulation.
Georgiadou
Panagiota
P
2nd Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece. pg171@hlk.forthnet.gr
Karavolias
George
G
Sbarouni
Eftihia
E
Adamopoulos
Stamatis
S
Malakos
John
J
Voudris
Vassilis
V
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D021721:Balloon Occlusion; D002305:Cardiac Tamponade / Q000209:etiology / Q000628:therapy; D002404:Catheterization; D015984:Causality; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006335:Heart Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020519:Pericardiocentesis; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy