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Myocardial Infarction and Functional Outcome Assessment in Pigs
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Incidence, predictors, management and outcomes of coronary perforations

Arslan Shaukat1, Peter Tajti1, Yader Sandoval2

  • 1Minneapolis Heart Institute, Abbott Northwestern Hospital and Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 13, 2018
PubMed

Insights

Coronary perforation, a rare complication of percutaneous coronary intervention (PCI), occurred in 0.51% of cases. Both large and distal vessel perforations are linked to high mortality, emphasizing prevention strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Complications

Background:

  • Coronary perforation is a rare but significant complication during percutaneous coronary intervention (PCI).
  • Limited data exists on large versus distal vessel perforations.
  • Understanding predictors and outcomes is crucial for patient management.

Purpose of the Study:

  • To examine the incidence, types, predictors, and outcomes of coronary perforation following PCI.
  • To compare outcomes between large vessel and distal vessel perforations.
  • To identify risk factors and management strategies for coronary perforation.

Main Methods:

  • Retrospective observational cohort study (2009-2016) of patients undergoing PCI.
  • Analysis of angiograms to determine perforation mechanism, type, and management.
  • Risk-adjusted comparison of periprocedural complications and one-year mortality.

Main Results:

  • Coronary perforation occurred in 0.51% of 13,339 PCIs, with 75% being large vessel and 25% distal vessel perforations.
  • Large vessel perforations were mainly caused by balloon/stent inflation, while distal perforations resulted from guidewire exit.
  • Patients with perforation had a 7.57-fold increased risk of complications; in-hospital mortality was high for both types (7.8% large, 11.8% distal).

Conclusions:

  • Coronary perforation is an infrequent but serious PCI complication.
  • While rarely requiring emergency surgery, both distal and large vessel perforations are associated with significant in-hospital mortality.
  • Prevention of coronary perforation is critical due to its severe outcomes.
Abstract

Keywords:
PCIcomplicationscoronary perforationhealth care outcomes

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