Related Experiment Video
Updated: Feb 15, 2026
Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Temporal trends in frequency, management and outcomes of coronary perforations
Agustín Fernández-Cisnal1, Rafael Romaguera2, Marcos Ñato1
1Heart Disease Institute, Bellvitge University Hospital (IDIBELL), University of Barcelona, Barcelona, Spain.
Insights
Coronary perforations (CP) during percutaneous coronary interventions (PCI) increased over time but improved outcomes due to better device management. This study compares trends in CP frequency, treatment, and results.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Coronary perforations (CP) are rare but serious complications during percutaneous coronary interventions (PCI).
- Temporal trends in the frequency, management, and outcomes of CP require investigation.
Purpose of the Study:
- To compare temporal trends in the frequency, management, and outcomes of coronary perforations (CP) from 2003 to 2015.
- To analyze changes in CP occurrence and patient outcomes between an early and current period.
Main Methods:
- A prospective institutional PCI registry from 2003-2015 was analyzed.
- Patients were divided into an early period (pre-2009) and a current period.
- Primary endpoint: composite of in-hospital serious adverse events (SAEs).
Main Results:
- Overall CP rate was 0.50% (88/17,566 procedures).
- CP frequency increased from 0.26% in the early period to 0.64% in the current period (P<0.001).
- In-hospital SAEs decreased from 69% in the early period to 31% in the current period (P=0.037), with increased use of intracoronary devices.
Conclusions:
- Increased PCI complexity may contribute to a higher frequency of coronary perforations.
- Advances in technical and device management have improved the prognosis of CP.
Background:
Coronary perforations (CP) have been described as a rare but potentially fatal complication in percutaneous coronary interventions (PCI). Our aim is to compare temporal trends in frequency, management and outcomes of coronary perforations (CP).
Methods:
All cases of CP recorded in our prospective institutional percutaneous coronary intervention (PCI) registry from 2003 to 2015 were included. Patients were divided in 2 groups according to the time frame in which the CP occurred: the early period (before 2009, when the chronic total occlusions and primary PCI programs started) and the current period. The primary endpoint was the composite of in-hospital serious adverse events, including final TIMI flow 0-1, cardiac tamponade, emergent cardiac surgery or death.
Results:
Overall, 88 CP occurred in 17,566 procedures (0.50%). Of these, 17 (0.26%) occurred during the early period and 71 (0.64%) during the current period (P<0.001). CP management differed between groups, with less CP sealed by intracoronary devices in the early period than in the current one (23.5% vs. 47.9%, P=0.068). Moreover, patients with CP during the early period experienced more in-hospital serious adverse events (69% vs. 31% respectively, OR 3.18, 95% CI: 1.07-9.45, P=0.037).
Conclusions:
Expansion of indications and complexity of PCI in the current era may be associated with an increased frequency of CP. However, progress in technical and device management of CP have led to an improvement in the prognosis of this feared complication.
Related Concept Videos
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:26Acute Coronary Syndrome V: Nursing Management
01:22Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
01:28Current Trends in Nursing I
01:30Current Trends in Nursing II
02:24Predicting Reaction Outcomes