Management and outcomes of coronary artery perforations during percutaneous treatment of acute coronary syndromes.
BACKGROUND
Coronary artery perforation (CAP) is an infrequent and life-threatening complication of percutaneous coronary intervention (PCI), requiring prompt intervention. There is insufficient data about the prognosis and management of CAP in patients with acute coronary syndrome (ACS). The aim of this study was to investigate the management of CAP in patients with ACS.


METHODS
The results of 25 patients with CAP were retrospectively analyzed.


RESULTS
Of the 25 patients, 14 patients (56%) had ACS. According to the Ellis classification, the grade of perforation was type-I in 8 (32%) patients, type-II in 6 (24%) patients and type-III in 11 (44%) patients. Prolonged balloon inflation was performed to 20 (80%) cases of CAP. It successfully sealed the perforation in three cases of type-I, five cases of type-II CAP and in seven cases of type-III CAP. Seven patients underwent covered stent implantation. Emergent CABG was required in two patients with type-III CAP. In-hospital mortality was not observed in the patients.


CONCLUSIONS
The outcomes of CAP in patients with ACS were similar to patients with stable coronary disease. The continuation of anti-platelet agents after the successful management of CAP may be encouraged in these patients.
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey ahmetaykan@yahoo.com.
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Aykan
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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Güler
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
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Gül
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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Karabay
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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Alizade
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
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Gökdeniz
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
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Kalaycıoğlu
Department of Cardiology, Ahi Evren Chest and Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey.
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Çetin
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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Yıldız
D054058:Acute Coronary Syndrome / Q000628:therapy*; D000368:Aged; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000293:injuries*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D012189:Retrospective Studies; D012421:Rupture / Q000209:etiology / Q000517:prevention & control*
coronary; graft stent; myocardial infarction; percutaneous coronary intervention; perforation; rupture