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Expecting the unexpected: preventing and managing the consequences of coronary perforations

Peter Tajti1,2, Iosif Xenogiannis1, Ivan Chavez1

  • 1a Minneapolis Heart Institute , Abbott Northwestern Hospital , Minneapolis , MN , USA.

Expert Review of Cardiovascular Therapy
|October 20, 2018
PubMed

Insights

Coronary artery perforations during percutaneous coronary intervention (PCI) are linked to complex lesions. A structured approach to managing these perforations, focusing on guidewire and device selection, improves outcomes.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Research

Background:

  • Coronary artery perforations frequently complicate percutaneous coronary intervention (PCI), particularly with complex lesions like calcified arteries and chronic total occlusions.
  • Minimizing perforation risk hinges on careful guidewire manipulation and appropriate device selection during PCI procedures.

Purpose of the Study:

  • To provide an updated review of the management strategies for coronary artery perforations.
  • To critically analyze recent literature concerning coronary perforation treatment.

Main Methods:

  • A comprehensive literature search was conducted focusing on recently published studies related to coronary artery perforations.
  • The review critically evaluated management techniques and outcomes reported in the selected literature.

Main Results:

  • Complex coronary lesions present a higher risk for perforation during PCI.
  • Meticulous attention to guidewire position and device choice is crucial for preventing coronary perforations.
  • A structured, algorithmic approach to managing perforations significantly increases the probability of a successful clinical outcome.

Conclusions:

  • Coronary artery perforations require careful management strategies.
  • Adherence to best practices in guidewire handling and device selection can mitigate perforation risks.
  • Implementing a systematic management protocol is key to optimizing patient outcomes following coronary perforation.
Abstract

Keywords:
Perforationcomplex coronary interventionscomplicationoutcomespercutaneous coronary interventions

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