Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention

Gruberg, Luis; Pinnow, Ellen; Flood, Roy; Bonnet, Y; Tebeica, Mihaela; Waksman, Ron; Satler, Lowell F.; Pichard, Augusto D.; Kent, Kenneth M.; Leon, Martin B.; Lindsay, Joseph

doi:10.1016/s0002-9149(00)01053-5

Cited by 168 publications

(142 citation statements)

References 17 publications

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“…Факторы риска развития острой КИН [9] Контраст-индуцированная нефропатия/ Contrast-Induced Nephropathy 3,3-16,5% [13] Холестериновые эмболии/Cholesterol embolism < 2% 25%-30% (по данным аутопсии)/ (according to autopsy data) [14] Повреждение сосудов/Damage to blood vessels 0,7% -11,7% [15,16,17] Брадиаритмии/Bradyarrhythmias 3,5% [18] Летальность/Mortality 3% (диссекция левой коронарной артерии)/ (left coronary artery dissection) [19] Инфаркт миокарда/Myocardial infarction 0,05%-0,07% [20,21] Цереброваскулярные осложнения/ Cerebrovascular complications Диссекция коронарных артерий/ Dissection of the coronary arteries 0,3-0,6% [22] Ятрогенные события при эндоскопических проце-дурах могут проявляться не только осложнениями со стороны исследуемого органа (пищевод, желудок, ки-шечник), но и зависят также от состояния больного, его подготовки к проведению процедуры, техникой эндоскопии [25,26].…”

Section: осложнения при эндоскопических исследованияхunclassified

Iatrogenic left main coronary artery dissection: Incidence, classification, management, and long-term follow-up

Eshtehardi

Adorjan

Togni

et al. 2010

American Heart Journal

102

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РезюмеОсобую группу ятрогений составляют осложнения, связанные с различными диагностическими манипуляциями -от физикального об-следования больного до ангиографических исследований, диагностической лапароскопии или торакоскопии. В статье приводятся данные о частоте и характере диагностических ятрогений в клинической практике. Диапазон диагностических ятрогений по своим проявлениям, тяжести и прогнозу достаточно широк -от раздражения кожи гелем при проведении УЗИ до диссекции коронарной артерии во время коро-нароангиографии. В статье представлены примеры ятрогений диагностических процедур, начиная с процесса клинического обследования (сбор жалоб и анамнеза, физикальное исследование), и заканчивая сложными инвазивными обследованиями. Подробно рассмотрены ятро-гении, возникающие при применении препаратов, содержащих контраст (в частности йодсодержащих препаратов), которые достаточно ши-роко используются в клинической практике (КТ с контрастированием, ангиографии и др.) с диагностической целью. В статье рассказывается о факторах риска, знание которых и осведомленность об их наличии у пациента обязательны перед введением препаратов, содержащих контраст. Проведен обзор осложнений, возникающих при эндоскопических исследованиях. Автор напоминает, что ятрогенные события при эндоскопических процедурах могут проявляться не только осложнениями со стороны исследуемого органа (пищевод, желудок, кишечник), но зависят также и от состояния больного, его подготовки к проведению процедуры, владения специалистом техникой эндоскопии. В за-ключение автор приводит клиническое наблюдение, в котором фактором риска ятрогенного события было наличие у больной аномалии протоковых систем печени и поджелудочной железы. Автор статьи призывает коллег более внимательно относиться к процессу принятия решения о проведении диагностического исследования, всегда оценивать соотношение польза/риск с точки зрения реальной пользы диа-гностического исследования для больного и риска развития осложнения. Ключевые слова: ятрогения, контраст-индуцированная нефропатия, коронароангиография, эндоскопия, эзофагогастродуоденоско-пия, колоноскопия AbstractA special group of iatrogenic complications are associated with various diagnostic manipulations -from a physical examination of the patient to angiographic studies, diagnostic laparoscopy or thoracoscopy. The article presents data on the frequency and nature of diagnostic iatrogenic in clinical practice. The range of diagnostic iatrogenesis in terms of its manifestations, severity and prognosis is wide enough -from skin irritation with gel during ultrasound to dissection of the coronary artery during coronary angiography. The article presents examples of iatrogenic diagnostic procedures, starting with the clinical examination process (collection of complaints and anamnesis, physical examination), and ending with complex invasive examinations. Yatrogenia, which occur with the use of preparations containing contrast (in particular iodine-containing drugs), which are widely used in clinical practice (CT with contras...

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Section: осложнения при эндоскопических исследованияхunclassified

Iatrogenic left main coronary artery dissection: Incidence, classification, management, and long-term follow-up

Eshtehardi

Adorjan

Togni

et al. 2010

American Heart Journal

102

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“…Its incidence was reported to be 0.2% -0.6% [1,2].The diagnosis and classification of coronary perforation have been shown in the previous studies [3,4]. In our country, this situation was reported only as case reports in the medical literature, but there was no prospective study about this issue [5].…”

Section: Introductionmentioning

confidence: 81%

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Yıldız¹,

Karakurt²,

Bitigen³

et al. 2013

Health

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Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20% -0.6%. Its sudden development, the patient's agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women; the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.

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“…Previous studies reported that the incidence of grade I to III coronary perforations ranges from 0.1% to 3.0% 2,3 . In 2011, Rasha Al-Lamee et al conducted a study focused only on grade III coronary perforations, and they reported that this remains rare, with an incidence of 0.23% 4 .…”

Section: Discussionmentioning

confidence: 98%

Grade III Coronary Artery Perforation Following PCI and Unusual Stent Graft Delivery System

Srećković

Jagić

Miloradović

et al. 2014

Serbian Journal of Experimental and Clinical Research

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ABBREVIATIONS PCI-percutaneous coronary interventionPTFE-polytetrafluoroethylene NSTEMI-non ST segment elevation myocardial infarction LVH-left ventricular hypertrophy LAD-left anterior descending artery D1-first diagonal branch S1-first septal branch RCA-right coronary artery SC-semi compliant balloon DES-drug eluting stent BMS-bare metal stent CPR-cardiopulmonary resuscitation CABG-coronary artery bypass graft CASE REPORTA 68 year old female was admitted to the cath lab due to complaints of postinfarction angina. She suffered an anterior NSTEMI 5 months prior to presentation. Her risk factors for cardiovascular disease were as follows: hypertension, diabetes, dyslipidemia, and a history of smoking. An electrocardiogram showed sinus rhythm, with a rate of 75 bpm, as well as signs of LVH and a reduced R in V2. Echocardiography revealed a reduced ejection fraction -40% and anterior wall hypokinesia. Angiography was performed, showing that the LAD was diffusely atherosclerotic and calcified, with tight stenosis approaching 90% of the vessel lumen immediately after the D1 and S1 branches (Figure1).

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Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention

Cited by 168 publications

References 17 publications

Iatrogenic left main coronary artery dissection: Incidence, classification, management, and long-term follow-up

Iatrogenic left main coronary artery dissection: Incidence, classification, management, and long-term follow-up

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Grade III Coronary Artery Perforation Following PCI and Unusual Stent Graft Delivery System

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