Angiographic Success and Procedural Complications in Patients Undergoing Percutaneous Coronary Chronic Total Occlusion Interventions

Patel, Vishal; Brayton, Kimberly; Tamayo, Aracely; Mogabgab, Owen; Michael, Tesfaldet T.; Lo, Nathan; Alomar, Mohammed; Shorrock, Deborah; Cipher, Daisha J.; Abdullah, Shuaib; Banerjee, Subhash; Brilakis, Emmanouil S.

doi:10.1016/j.jcin.2012.10.011

Cited by 327 publications

(227 citation statements)

References 29 publications

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“…This finding contrasts with previous clinical studies, which reported malignant diseases as the most common cause of pericardial tamponade, reaching 30-60% of cases [6][7][8][9][10][11]. This shift in tamponade etiology is apparently due to the increase in recent years in the overall number and in the complexity of percutaneous intra-cardiac procedures, as well as the introduction of interventional techniques such as trans-catheter valve replacement and catheter ablation for atrial fibrillation, all reported to be possibly complicated by cardiac tamponade [12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Contemporary evaluation of the causes of cardiac tamponade: Acute and long-term outcomes

et al. 2016

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Results: Cardiac tamponade was observed in 83 patients (52% females). Major etiologies included complications of percutaneous cardiac interventions (36%) and malignancies (primarily lung cancer; 23%), infectious/inflammatory causes (15%) and mechanical complications of myocardial infarction (12%). Sixteen (19%) patients died during the index hospitalization. Acute presentation of symptoms and lower quantity of effusion were associated with in-hospital mortality (p = 0.045 and p = 0.007). Tamponade secondary to malignancy was associated with the most substantial increment in post-discharge mortality (from 16% in-hospital to 68% 1-year mortality). During the mean follow-up of 45 months, 39 (45%) patients died. Malignancies, mechanical complications of myocardial infarction and bleeding/coagulation abnormalities were etiologies associated with poor survival (80% mortality during follow-up). Tamponade secondary to complications of percutaneous cardiac interventions or infectious/inflammatory causes were associated with significantly lower mortality (28% and 17%; log rank p < 0.001 (Cardiol J 2016; 23, 1: 57-63)

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Section: Discussionmentioning

confidence: 99%

Contemporary evaluation of the causes of cardiac tamponade: Acute and long-term outcomes

et al. 2016

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“…Since the pooling of blood was observed at the distal portion of the vessel, we conjecture that a floppy guidewire penetrated the intima of the vessel and advanced into the sub-epicardial space. A meta-analysis of the risk of complications during CTO coronary intervention demonstrated that coronary perforation is not a rare complication and has an incidence rate of 2.9%, but that cardiac tamponade and death are rare with incidence rates of 0.3% and 0.2%, respectively [8]. Cardiac tamponade is generally caused by pooling of blood in the pericardial space between the epicardium and pericardium.…”

Section: Discussionmentioning

confidence: 99%

Cardiogenic Shock Caused by a Large Sub-Epicardial Hematoma Complicating Percutaneous Coronary Intervention

Higuchi¹,

Fukamachi²,

Fujii³

et al. 2015

CRCM

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A 56-year-old man with a history of old myocardial infarction and coronary artery bypass grafting was performed percutaneous coronary intervention to the totally occluded lesion of native left anterior descending artery. He developed a coronary arterial perforation that led to a large dissecting sub-epicardial hematoma. Emergent surgery was performed, and a large hematoma was removed from the sub-epicardial space. Continuous drainage of blood was observed after surgery, and the patient died due to the development of multiorgan dysfunction. An autopsy revealed an extensive sub-epicardial hematoma on the lateral wall of the left ventricle and broad necrosis of the myocardium in the lateral wall.

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“…A meta‐analysis of 65 studies published between 2000 and 2011 reported 77% angiographic success and 3.1% risk for MACE 24. In recent years, several large multicenter registries have reported higher success (≈85%–90%) with acceptable complication rates in CTO PCI at various experienced centers and with operators from all around the world, although less optimal results have been reported from all‐comer PCI registries (Table 2).…”

Section: Success Of Cto Pcimentioning

confidence: 99%

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

Tajti

Brilakis

2018

JAHA

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Angiographic Success and Procedural Complications in Patients Undergoing Percutaneous Coronary Chronic Total Occlusion Interventions

Abstract: CTO PCI carries low risk for procedural complications despite high success rates.

Cited by 327 publications

References 29 publications

Contemporary evaluation of the causes of cardiac tamponade: Acute and long-term outcomes

Contemporary evaluation of the causes of cardiac tamponade: Acute and long-term outcomes

Cardiogenic Shock Caused by a Large Sub-Epicardial Hematoma Complicating Percutaneous Coronary Intervention

Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies

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