Clinical study of coronary artery perforation during percutaneous coronary interventions / 中国实用内科杂志

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(incidence0.5%).These cases are comparatively complicated lesions including 81.3% of type B2+C and 62.5% of chronic total occlusion(CTO)lesions.Ellis classificationtypeⅠ14(43.8%),type Ⅱ10(31.2%),type Ⅲ8(25.0%),type Ⅳ0.Mechanism of coronary artery perforationguiding wire21(65.6%),predilatation6(18.8%),postdilatation3(9.4%),stent implantation2(6.2%).Clinical consequencedeath3(9.4%),cardiac temponade7(21.9%),acute myocardial infarction(AMI)9(28.1%).Treatmentreversal of heparin-induced anticoagulation by application of protamine14(43.8%),prolonged balloon inflation9(28.1%),percardiocentesis7(21.9%),implantation of membrane covered stent4(12.5%),bail-out surgical repair2(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.