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Acute and long-term outcome after coronary artery perforation during percutaneous coronary interventions

H Eggebrecht1, A Ritzel, C von Birgelen

  • 1Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany. holger.eggebrecht@uni-essen.de

Zeitschrift Fur Kardiologie
|October 20, 2004
PubMed

Insights

Coronary artery perforation during percutaneous coronary interventions (PCI) is rare but serious. Non-surgical management is often successful for this complication, despite associated morbidity and mortality.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery perforation is a rare but serious complication during percutaneous coronary interventions (PCI).
  • The incidence of coronary perforation during PCI is approximately 0.3%.

Purpose of the Study:

  • To review the mechanisms, management, and outcomes of coronary perforation during PCI.
  • To evaluate the efficacy of non-surgical management strategies for coronary artery perforation.

Main Methods:

  • Retrospective review of a database for coronary perforation cases during PCI procedures (01/1998-12/2003).
  • Analysis of hospital charts, procedural reports, and coronary angiograms.
  • Emphasis on perforation mechanisms, management strategies, and clinical outcomes.

Main Results:

  • 19 cases of coronary perforation occurred during 6433 PCI procedures.
  • Perforation frequently occurred during chronic total occlusion recanalization (63%).
  • Non-surgical management was attempted in most cases (95%), with prolonged balloon inflation (53%) and stenting (32%) being common interventions. Cardiac tamponade occurred in 16% of patients, and 11% required surgical repair. Early mortality was 11%.

Conclusions:

  • Coronary perforation during PCI, though rare, leads to significant morbidity and mortality.
  • Non-surgical management is feasible and successful in the majority of patients.
  • Effective management strategies can mitigate the risks associated with this complication.
Abstract

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