Management of percutaneous coronary intervention complications

Kandan, Sri Raveen; Johnson, Tom

doi:10.1136/heartjnl-2017-311155

Cited by 27 publications

(20 citation statements)

References 46 publications

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“…Since decades of medical advancement, coronary angiography (CAG) and percutaneous coronary intervention (PCI) have remained the mainstay treatments for coronary artery disease. As the complexity of the procedure increases to include broader indications of chronic total occlusion, calcified coronary disease, and cardiogenic shock [6], the likelihood of complications related to the procedure may increase despite the contribution of the procedures to better prognosis.…”

Section: Introductionmentioning

confidence: 99%

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Hyeon

Lee

Kim

et al. 2020

Korean J Intern Med

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Background/Aims: Possible fatal complications arising from coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery disease itself, are likely to cause medical disputes. Presenting the current status and reasons for judgments given in lawsuits related to CAG/PCI, this study aimed to identify ways to prevent unnecessary disputes and medical malpractice suits related to CAG/PCI through lawsuit analysis. Methods: A total of 13 cases (20 judgments) found in the Supreme Court of Korea's Written Judgment Management System from 1998 to 2017 were analyzed. Results: Coronary artery injury was the most common causative complication that led to lawsuits (n = 6, 46%). Six cases (46%) were ruled in favor of the plaintiff for violation of duty of care (n = 4) and duty of explanation (n = 2), respectively. Cases that violated duty of care included two errors in intra-procedure device manipulation, one in pre-procedure diagnosis, and one in management of post-procedure complication. Lack of explanation regarding the risk of complications was pointed out in both cases that violated duty of explanation. The average awarded amount for the damages was 114,436,064 Korean won. Conclusions: Physicians need not fear unfair judgments so long as they follow standard of care because the Court consistently looked at the probability, the foreseeability, and the evidence. Therefore, maintaining standard of care is important. Besides, specific, detailed, and comprehensible explanations, including the risk of complications in addition to the necessity of procedures, are important to ensure the patient clearly understands the possible risk of adverse outcomes.

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Section: Introductionmentioning

confidence: 99%

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Hyeon

Lee

Kim

et al. 2020

Korean J Intern Med

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“…Those with thrombus present in the coronary aneurysm, but without complete vessel occlusion, should be considered for intravenous thrombolysis and intensification of antithrombotic measures. Successful thrombolysis can be achieved in over 50% of patients with aneurysms using repeated daily infusion of tissue plasminogen activator (tPA) (alteplase) 37 38. If thrombosis has occurred despite anticoagulation with warfarin, intensification of antithrombotic treatment by transfer to unfractionated heparin, switching to a DOAC and addition of other antiplatelet agents should be considered in adults and might be a possibility in children and young adults if their safety and efficacy is confirmed in the future.…”

Section: Transition From Paediatric To Adult Servicesmentioning

confidence: 99%

Lifetime cardiovascular management of patients with previous Kawasaki disease

Brogan¹,

Burns

Cornish³

et al. 2019

Heart

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Kawasaki disease (KD) is an inflammatory disorder of young children, associated with vasculitis of the coronary arteries with subsequent aneurysm formation in up to one-third of untreated patients. Those who develop aneurysms are at life-long risk of coronary thrombosis or the development of stenotic lesions, which may lead to myocardial ischaemia, infarction or death. The incidence of KD is increasing worldwide, and in more economically developed countries, KD is now the most common cause of acquired heart disease in children. However, many clinicians in the UK are unaware of the disorder and its long-term cardiac complications, potentially leading to late diagnosis, delayed treatment and poorer outcomes. Increasing numbers of patients who suffered KD in childhood are transitioning to the care of adult services where there is significantly less awareness and experience of the condition than in paediatric services. The aim of this document is to provide guidance on the long-term management of patients who have vascular complications of KD and guidance on the emergency management of acute coronary complications. Guidance on the management of acute KD is published elsewhere.

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“…Managing patients with CHD has been substantially improved, and since Gruntzig's rst angioplasty, percutaneous coronary intervention (PCI) has become one of the most frequently performed therapeutic interventions [3,4]. However, complications associated with PCI still exist [5]. Up to one-quarter of patients may have either continues or recurrent post-PCI chest pain (PPCP) [6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of Yinxing Mihuan oral solution in the treatment of patients with post-PCI chest pain: A multicenter, prospective, randomized, double-blind, placebo-controlled study

et al. 2021

Preprint

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Background：Coronary artery disease (CHD) now accounts for approximately one third of all deaths globally and up to one-quarter of patients may have either continues or recurrent post-PCI chest pain. Yinxing Mihuan oral solution (YMOS) has been proven to bring clinical benefits for patients with CHD and Ginkgo biloba extract can relieve depression in mice. No high-quality randomized controlled trials on YMOS have been published. The aim of this study is to evaluate the efficacy and safety of Yinxing Mihuan oral solution (YMOS) in the treatment of patients with post-percutaneous coronary intervention (PCI) chest pain. This study also aimed to relieve the symptoms of chest pain as a primary outcome, improve the anxiety as a secondary outcome, assess therapeutic effects of YMOS on chest pain, and explore its effects on chest pain caused by psychological disorders after PCI.Methods: 320 patients with symptoms related to heart and a confirmed history of PCI for coronary heart disease (CHD) without the need to undergo selective coronary revascularization plan were recruited in this randomized controlled trial. The included participants were randomly assigned (at a ratio of 1:1) to experimental group and control group; patients in the experimental group received YMOS and standardized medical treatment, while those in control received placebo (10 ml) for three times/day for 12 weeks and standardized medical treatment regimen. The endpoints of the study included Seattle angina questionnaire (SAQ) score, Hamilton anxiety rating scale (HAMA), Hamilton rating scale for depression (HRSD), Canadian Cardiovascular Society (CCS) angina score, New York Heart Association (NYHA) classification, visual analogue scale (VAS), 12-Item short form survey (SF-12), frequency of angina-related symptoms per week, nitroglycerin discontinuation, and reduction rate of HAMA score.Discussion: This clinical trial can provide reliable evidence regarding the efficacy and safety of YMOS for patients with post-PCI chest pain.Trial registration: This research has been registered at the Chinese Clinical Trial Registry (Registration No. ChiCTR2000028760) on January 1, 2020. http://www.chictr.org.cn/showproj.aspx?proj=47528

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Management of percutaneous coronary intervention complications

Cited by 27 publications

References 46 publications

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Prevention of medical malpractice and disputes through analysis of lawsuits related to coronary angiography and intervention

Lifetime cardiovascular management of patients with previous Kawasaki disease

Efficacy and safety of Yinxing Mihuan oral solution in the treatment of patients with post-PCI chest pain: A multicenter, prospective, randomized, double-blind, placebo-controlled study

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