Incidence, correlates, management, and clinical outcome of coronary perforation: analysis of 16,298 procedures. Am Heart J 2004 Jan;147(1):140-5
Date
12/24/2003Pubmed ID
14691432DOI
10.1016/s0002-8703(03)00505-2Scopus ID
2-s2.0-0346156028 (requires institutional sign-in at Scopus site) 169 CitationsAbstract
BACKGROUND: Coronary perforation is a serious but uncommon complication of percutaneous coronary intervention (PCI) and is associated with significant morbidity and mortality.
METHODS: We performed an analysis of the Mayo Clinic PCI database. Clinical records, procedural reports, and angiographic studies were reviewed. Multiple logistic regression analysis was performed to identify clinical, procedural, anatomic, and angiographic correlates of coronary perforation.
RESULTS: A total of 16,298 PCI procedures were performed between January 1990 and December 2001. We identified 95 coronary perforations (0.58%; 95% CI, 0.47-0.71). The incidence of coronary perforation varied with time. Correlates of coronary perforation included the use of an atheroablative device and female sex. Twelve patients (12.6%) sustained an acute myocardial infarction, and cardiac tamponade developed in 11 patients (11.6%). Management strategies included reversal of heparin, pericardiocentesis, placement of a covered stent, and surgical repair. Seven patients died (7.4%).
CONCLUSIONS: Coronary perforation during PCI is rare, but is associated with significant morbidity and mortality. The variable frequency of perforation may be explained by temporal variations in the use of atheroablative devices.
Author List
Fasseas P, Orford JL, Panetta CJ, Bell MR, Denktas AE, Lennon RJ, Holmes DR, Berger PBAuthor
Panayotis Fasseas MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAngioplasty, Balloon, Coronary
Atherectomy, Coronary
Constriction
Coronary Artery Disease
Coronary Vessels
Databases, Factual
Female
Humans
Incidence
Male
Platelet Glycoprotein GPIIb-IIIa Complex
Prospective Studies
Protamines
Regression Analysis
Stents
Wounds, Penetrating