Medical College of Wisconsin
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Incidence, correlates, management, and clinical outcome of coronary perforation: analysis of 16,298 procedures. Am Heart J 2004 Jan;147(1):140-5

Date

12/24/2003

Pubmed ID

14691432

DOI

10.1016/s0002-8703(03)00505-2

Scopus ID

2-s2.0-0346156028   159 Citations

Abstract

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 PB

Author

Panayotis Fasseas MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Angioplasty, 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