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Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention
Insights
Coronary artery perforation during percutaneous coronary intervention occurred more in women and with atheroablative devices. This serious complication led to death in 9.5% of patients, often associated with cardiac tamponade and emergency surgery.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Coronary artery perforation is a rare but serious complication of percutaneous coronary intervention (PCI).
- Understanding the incidence, management, and outcomes is crucial for improving patient care.
- Atheroablative devices are increasingly used for complex lesion modification.
Purpose of the Study:
- To analyze the incidence, management, and outcomes of coronary artery perforation following PCI.
- To identify risk factors associated with this complication.
- To evaluate mortality and treatment strategies in patients experiencing coronary artery perforation.
Main Methods:
- Retrospective analysis of 84 cases of coronary artery perforation.
- Review of patient demographics, procedural details, and outcomes.
- Comparison of characteristics between patients who survived and those who died.
Main Results:
- Coronary artery perforation incidence was higher in female patients.
- Atheroablative devices for lesion modification were associated with increased perforation risk.
- Mortality rate was 9.5% (8 patients), with older age and cardiac tamponade being common in non-survivors.
- A higher percentage of non-survivors required emergency surgery.
Conclusions:
- Coronary artery perforation during PCI is linked to specific patient demographics and device usage.
- Prompt recognition and management, including potential emergency surgery, are vital for improving outcomes.
- Further research into preventative strategies and optimized management protocols is warranted.
Abstract:
We have analyzed the incidence, management, and outcome of 84 cases of coronary artery perforation in patients who underwent percutaneous coronary intervention at our institution. This complication was more frequent in female patients and in patients who underwent lesion modification with atheroablative devices. A total of 8 patients (9.5%) died after the procedure. They were usually older and had a higher incidence of cardiac tamponade; a larger percentage of these patients underwent emergency surgery than those who survived.