Risks and Complications of Coronary Angiography: A Comprehensive Review

Tavakol, Morteza; Ashraf, Salman; Brener, Sorin J.

doi:10.5539/gjhs.v4n1p65

Cited by 199 publications

(200 citation statements)

References 195 publications

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“…являющаяся золотым стандартом диагностики и тя-жести ИБС, может быть причиной различных по тяжести и прогнозу ятрогенных осложнений [11]. В таблице 2 представлены основные осложнения и их частота у больных после коронароангиографии.…”

Section: коронароангиографияunclassified

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

Eshtehardi

Adorjan

Togni

et al. 2010

American Heart Journal

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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: коронароангиографияunclassified

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

Eshtehardi

Adorjan

Togni

et al. 2010

American Heart Journal

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“…194,195 Ventricular arrhythmias sel dom occur during coronary angiography, and if they do occur, it is frequently when the catheter is manipulated or in response to high osmolar ionic contrast dye, used infrequently today. 195,196 Major complications, including death, MI, or embolization during or after diagnostic cardiac angiography, are extremely rare (<1%), and pro cedural mortality has been reported to be 0.1%. 195,197 It is increasingly common to perform diagnostic cath eterizations in the ambulatory setting, and patients are often discharged several hours after uncomplicated coronary angiography.…”

Section: After Routine Diagnostic Coronary Angiographymentioning

confidence: 99%

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Sandau¹,

Funk²,

Auerbach³

et al. 2017

Circulation

181

195

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Background and Purpose: This scientific statement provides an interprofessional, comprehensive review of evidence and recommendations for indications, duration, and implementation of continuous electro cardiographic monitoring of hospitalized patients. Since the original practice standards were published in 2004, new issues have emerged that need to be addressed: overuse of arrhythmia monitoring among a variety of patient populations, appropriate use of ischemia and QT-interval monitoring among select populations, alarm management, and documentation in electronic health records. Methods: Authors were commissioned by the American Heart Association and included experts from general cardiology, electrophysiology (adult and pediatric), and interventional cardiology, as well as a hospitalist and experts in alarm management. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Authors were assigned topics relevant to their areas of expertise, reviewed the literature with an emphasis on publications since the prior practice standards, and drafted recommendations on indications and duration for electrocardiographic monitoring in accordance with the American Heart Association Level of Evidence grading algorithm that was in place at the time of commissioning. Results: The comprehensive document is grouped into 5 sections: (1) Overview of Arrhythmia, Ischemia, and QTc Monitoring; (2) Recommendations for Indication and Duration of Electrocardiographic Monitoring presented by patient population; (3) Organizational Aspects: Alarm Management, Education of Staff, and Documentation; (4) Implementation of Practice Standards; and (5) Call for Research. Conclusions: Many of the recommendations are based on limited data, so authors conclude with specific questions for further research.

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“…Na presente casuística, 1,4% dos pacientes desenvolveram essa condição. Com taxas relatadas na literatura que variaram de 3,3 a 16,5% [29] a avaliação da verdadeira incidência dessa situação é dificultada devido às variadas definições de insuficiência renal aguda aplicadas em pacientes com diferentes comorbidades. Fatores de risco importantes para insuficiência renal aguda incluem idade avançada, insuficiência renal crônica, insuficiência cardíaca, DM e volume de contraste administrado [18].…”

Section: Discussionunclassified

Caracterização do perfil e complicações intra-hospitalares dos pacientes submetidos ao cateterismo cardíaco em um hospital terciário

Braga

Silvano

Pereira

et al. 2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACT Aims:To evaluate the profile of patients undergoing cardiac catheterization and in-hospital complications associated with the procedure. Methods: Cross-sectional analysis of baseline data of a retrospective cohort study conducted in a tertiary care hospital in southern Brazil between 2007 and 2013. The study included patients undergoing diagnostic or therapeutic cardiac catheterization. The data were extracted from electronic medical records using a standardized form and stored in a database for further analysis. Results: Out of 994 assessed patients, 584 (58.8%) were male. The mean age was 61.4 years. Hypertension was the most prevalent risk factor, followed by dyslipidemia and diabetes mellitus. Regarding clinical presentation, 550 (55.3%) patients had acute coronary syndrome, 402 (40.4%) had stable angina, and 42 (4.2%) were asymptomatic. Cineangiography was normal in 152 (15.3%) patients and abnormal in 842 (84.7%). Of these, 251 (29.8%) had single vessel disease, 190 (22.6%) had double vessel disease, and 401 (47.6%) had triple vessel disease. The overall incidence of complications was 15.6%, and 1% of the patients suffered some kind of major event (death during the procedure and neurological complications during their hospital stay). Other complications included acute kidney injury (1.4%) and local vascular complications (13.2%), mainly hematoma at the puncture site. Fifty (5%) patients died during the hospital stay, 46 (92%) of them from cardiac causes. Conclusions:The patients undergoing cardiac catheterization were predominantly male, with mean age of 61.4 years. The most frequent risk factors for cardiovascular disease included hypertension, dyslipidemia, and diabetes mellitus. Most of the patients had triple vessel disease. The main indication for the procedure was acute coronary syndrome. The overall incidence of complications was 15.6% with predominance of hematoma at the puncture site.

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Risks and Complications of Coronary Angiography: A Comprehensive Review

Cited by 199 publications

References 195 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

Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association

Caracterização do perfil e complicações intra-hospitalares dos pacientes submetidos ao cateterismo cardíaco em um hospital terciário

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