Type III coronary perforation during chronic total occlusion percutaneous coronary interventions treated with Cyanoacrylate glue embolization: case report and review of the technique

Tumscitz, Carlo; Lanzillotti, Valerio; Pirani, Lucia; Cesare, A. Di; Scoccia, Alessandra; Gallo, Francesco

doi:10.20517/2574-1209.2018.71

Cited by 2 publications

(2 citation statements)

References 30 publications

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“…No suture technique using Tachosil to achieve hemostasis at site of perforation is obscured by epicardial hematoma is reported [6]. There is another technique described, using a percutaneous Cyanoacrylate/(NBCA-MS)-based glue infusion through a conventional CTO microcatheter, which has also demonstrated promising outcomes in Type III perforations [13].…”

Section: Discussionmentioning

confidence: 99%

Dreaded coronary artery perforations during percutaneous coronary artery interventions

Ramesh¹,

Varadaraju²,

Chandrasena³

et al. 2022

CSIC

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Spurting coronary artery in the pericardial cavity is observed rarely. Pericardial tamponade occurs and myocardial salvaging time starts ticking. Coronary artery perforations (CAP) have been quoted in literature to range from 0.1 % to 0.7 % of percutaneous coronary artery intervention (PCI) cases. Data was collected retrospectively from the patients of Sri Jayadeva Institute of Cardiovascular Sciences and Research in 2012-2019. A total of 2556 PCI were found in our database of which emergency surgical intervention were needed in 4 patients (0.15 %). Decision making in type 3 CAP with hemodynamic instability is highlighted. Although covered stents and balloons are used to stem the leak, importance of an on call cardiac surgeon cannot be exemplified if the situation is not under control.

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Section: Discussionmentioning

confidence: 99%

Dreaded coronary artery perforations during percutaneous coronary artery interventions

Ramesh¹,

Varadaraju²,

Chandrasena³

et al. 2022

CSIC

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“…Embolization methods, such as coil, 21 fat, 22 polyvinyl alcohol, 23 gelfoam, 24 N-butyl cyanoacrylate, 25 trombin injection, 26 microspheres, 27 glue, 28 and autologous blood clot, 29 can be applied as well In some perforations, late tamponades can be observed 24…”

Section: Discussionmentioning

confidence: 99%

Perkütan Koroner Girişime Bağlı İyatrojenik Koroner Arter Perfosyonu Gelişen Hastaların Demografik Özelliklerinin ve Tedavilerinin Değerlendirilmesi: Tek Merkez Deneyimi

Can

Sahinkus

2020

Sakarya Medical Journal

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Objective The aim of this study was to evaluate the demographic characteristics, frequency of perforation, clinical characteristics, treatment strategies and outcomes of patients who developed coronary artery perforation (CAP) during a percutaneous coronary intervention (PCI). Materials and Methods Patients who CAP during a PCI between January 2015 and January 2020 were included in the study. In this five-year period, 25 out of 10,794 patients who underwent PCI developed CAP. Outcomes were classified as cardiac tamponade, requiring urgent revascularization by bypass or PCI, in-hospital mortality, and 30-day mortality. Results In our study, frequency of CAP during PCI was 0.23%. Seventeen patients (68%) were male. The mean age of the patients was 62,52 ± 9.60 years. Eight patients had diabetes, 17 patients had hypertension and 5 patients had a history of chronic kidney disease. According to the Ellis classification system; rates of Ellis types I, II, III, and III-CS were 8 (32%), 9 (36%), 7 (28%), and 1 (4%), respectively. In 12 patients, tamponade was observed, and 7 of these patients underwent pericardiocentesis immediately, while 4 patients underwent pericardiocentesis on their follow-up (>24 hours). In three patients, type I perforation was initially unnoticed and tamponade was observed during follow-up. Six patients died in the hospital. In remaining patients, no mortality was observed within 30 days. In our study, the rates of adverse events for Ellis types I, II and III/III-CS, were as follows: cardiac tamponade, 12%, 20%, and 16%, respectively; emergency surgery, 0%, 4%, and 0% respectively; and death, 12%, 4%, and 8%, respectively. Conclusion Although CAPs are very rare, they have quite a high mortality. Interventional cardiologists should be aware of the risk for Ellis type 1 perforations, especially, because they may not be noticed during the PCI. These data should be evaluated by studies conducted with larger numbers of patients. Keywords Coronary artery perforation; percutaneous coronary intervention; graft-coated stent Öz Amaç Bu çalışmanın amacı perkutan koroner girişim sırasında koroner arter perforasyonu gelişen hastaların demografik özelliklerini, sıklığını, klinik özelliklerini, tedavi stratejilerini ve sonuçlarını değerlendirmektir. Gereç ve Yöntemler 2015 ocak ve 2020 ocak ayları arasında perkütan koroner girişim yapılması sırasında koroner arter perforasyonu gelişen hastalar çalışmaya dahil edildi. Perkütan koroner girişim yapılan 10794 hastanın 25 tanesinde koroner arter perforasyonu gelişti. Kardiyak tamponad, acil perkütan veya baypas ile revaskülarizasyon gereksinimi, hastane içi ve 30 günlük mortalite sonlanım noktaları olarak belirlendi.

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Type III coronary perforation during chronic total occlusion percutaneous coronary interventions treated with Cyanoacrylate glue embolization: case report and review of the technique

Cited by 2 publications

References 30 publications

Dreaded coronary artery perforations during percutaneous coronary artery interventions

Dreaded coronary artery perforations during percutaneous coronary artery interventions

Perkütan Koroner Girişime Bağlı İyatrojenik Koroner Arter Perfosyonu Gelişen Hastaların Demografik Özelliklerinin ve Tedavilerinin Değerlendirilmesi: Tek Merkez Deneyimi

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