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. 1994 Jul;32(3):206-12.
doi: 10.1002/ccd.1810320303.

Perforations after percutaneous coronary interventions: clinical, angiographic, and therapeutic observations

Affiliations

Perforations after percutaneous coronary interventions: clinical, angiographic, and therapeutic observations

S C Ajluni et al. Cathet Cardiovasc Diagn. 1994 Jul.

Abstract

Coronary perforation is a rare, but potentially catastrophic, complication of percutaneous coronary intervention. A retrospective review of the Cardiology Quality Assurance Database was performed for all percutaneous coronary interventions (n = 8,932) at William Beaumont Hospital from October 1988 to December 1992. Coronary artery perforation was reported in 35 patients (0.4%), including after percutaneous transluminal coronary angioplasty (PTCA, 11/7,905, 0.14%), transluminal extraction coronary atherectomy (TEC, 6/420, 1.3%), directional coronary atherectomy (DCA, 1/249, 0.25%), and excimer laser coronary angioplasty (ELCA, 5/242, 2%); and none after high-speed mechanical rotational atherectomy with the Rotablator (MRA, 0/116, 0%). Perforations were classified by coronary angiography as free perforations (n = 10), contained perforations (n = 17), or other types of perforation (n = 8). Although perforation was apparent in 32 (91%) of 35 angiograms, delayed cardiac tamponade occurred in 3 patients (9%), despite the absence of angiographic evidence for perforation at the time of the procedure. Causes of perforation were the guidewire in 7 (20%), an interventional device in 26 (74%), and indeterminate in 2 (6%). Complex B2 or C lesions accounted for 83% of perforations. Final treatment included conservative therapy (reversal of anticoagulation and/or PTCA) in 22 (63%) and surgical intervention (with or without bypass surgery) in 13 (37%). Serious clinical complications included cardiac tamponade in 6 (17%), blood transfusion in 12 (34%), myocardial infarction in 9 (26%), and death in 3 (9%).

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  • PACE, but with grace.
    Sharifi M, Koch M, Steele R, Pompili V. Sharifi M, et al. Catheter Cardiovasc Interv. 2001 Apr;52(4):535-6. doi: 10.1002/ccd.1117. Catheter Cardiovasc Interv. 2001. PMID: 11285614 No abstract available.

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