Clinical study of coronary artery perforation during percutaneous coronary interventions
- VernacularTitle:经皮冠状动脉介入治疗术中冠状动脉穿孔32例临床分析
- Author:
Zhan GAO
;
Yuejin YANG
;
Jilin CHEN
- Publication Type:Journal Article
- Keywords:
PCI;
Coronary artery perforation
- From:
Chinese Journal of Practical Internal Medicine
2006;0(15):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize clinical characteristics of coronary artery perforation during percutaneous coronary interventions.Methods Retrospective analysis of consecutive 32 patients who had coronary artery perforation in Fu Wai Hospital from April,2004 to August,2006 was carried out.Results Thirty-two cases of coronary perforation occurred during 7102 PCI procedures performed within this period(incidence:0.5%).These cases are comparatively complicated lesions including 81.3% of type B2+C and 62.5% of chronic total occlusion(CTO)lesions.Ellis classification:typeⅠ:14(43.8%),type Ⅱ:10(31.2%),type Ⅲ:8(25.0%),type Ⅳ:0.Mechanism of coronary artery perforation:guiding wire:21(65.6%),predilatation:6(18.8%),postdilatation:3(9.4%),stent implantation:2(6.2%).Clinical consequence:death:3(9.4%),cardiac temponade:7(21.9%),acute myocardial infarction(AMI):9(28.1%).Treatment:reversal of heparin-induced anticoagulation by application of protamine:14(43.8%),prolonged balloon inflation:9(28.1%),percardiocentesis:7(21.9%),implantation of membrane covered stent:4(12.5%),bail-out surgical repair:2(6.2%).Conclusion Coronary perforation during PCI is a rare complication;type Ⅲ perforation is associated with significant morbidity and mortality,which needs urgent and intensive treatment.
