Key result
Coronary perforations occurred in 0.1% (5 of 2991) of patients undergoing percutaneous coronary intervention, with 2 requiring pericardiocentesis and 1 resulting in death.
Why the study?
What is the incidence, management, and clinical outcome of coronary perforations in patients undergoing percutaneous coronary intervention?
Observational (n=2,991)
No
What is the incidence, management, and clinical outcome of coronary perforations in patients undergoing percutaneous coronary intervention?
Coronary perforation is a rare (0.1%) but potentially fatal complication of PCI that requires rapid detection, angiographic classification, and immediate management.
Low incidence of coronary perforation during PCI with occasional fatality warrants continued vigilance; extends observational estimates but leaves open preventive strategies.
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.
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Γεωργιάδου et al. (2009) conducted an observational in Coronary artery perforation during percutaneous coronary intervention (n=2,991). Percutaneous coronary intervention was evaluated on Incidence of coronary perforations. Coronary perforations occurred in 0.1% (5 of 2991) of patients undergoing percutaneous coronary intervention, with 2 requiring pericardiocentesis and 1 resulting in death.
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