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Coronary Angiography During Ex-Situ Heart Perfusion in a Porcine Model
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Coronary artery perforation in patients undergoing percutaneous coronary intervention: a single-centre report

Panagiota Georgiadou1, George Karavolias, Eftihia Sbarouni

  • 12nd Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece. pg171@hlk.forthnet.gr

Acute Cardiac Care
|September 11, 2009
PubMed

Insights

Coronary perforations during percutaneous coronary intervention are rare (0.1%). Prompt management, including balloon inflation and pericardiocentesis, is crucial for patient outcomes, though complications like cardiac tamponade and mortality can occur.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Coronary perforations are infrequent but serious complications during percutaneous coronary intervention (PCI).
  • Understanding their incidence, management, and outcomes is vital for improving patient care.

Purpose of the Study:

  • To report the incidence, management strategies, and clinical outcomes of coronary perforations in patients undergoing PCI.
  • To analyze the types and causes of coronary perforations and their associated treatments.

Main Methods:

  • Retrospective analysis of 2991 patients undergoing PCI.
  • Classification of perforations (Type I, II, III) based on angiographic findings.
  • Documentation of interventions, complications, and follow-up data.

Main Results:

  • Five cases (0.1%) of coronary perforation were identified.
  • Perforations varied in type (1 Type I, 1 Type II, 3 Type III) and etiology (guidewire, stent deployment, balloon post-dilatation).
  • Successful restoration was achieved in three cases with prolonged balloon inflation; two patients developed cardiac tamponade requiring pericardiocentesis, and one patient died.

Conclusions:

  • Coronary perforation during PCI is a rare event with significant potential for morbidity and mortality.
  • Effective management involves rapid detection, accurate classification, prompt occlusion, pericardiocentesis, hemodynamic support, and anticoagulation reversal.
  • While outcomes can be severe, a significant proportion of patients can achieve asymptomatic status post-intervention.

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