Early and Late Clinical Outcomes Following Coronary Perforation in Patients Under-going Percutaneous Coronary Intervention
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概要
- 論文の詳細を見る
Coronary perforation is a rare but serious complication that occurs during percutaneous coronary intervention (PCI). This study examines the frequency of coronary perforation during PCI, evaluates the management strategies used to treat perforations, and describes the long-term prognosis of patients who have developed coronary perforation during PCI. Coronary perforations were found in 69 (0.93%) of 7,443 consecutive PCI procedures, occurring more often after use of a new device (0.86%) than after use of balloon angioplasty (0.41%) (p<0.05). Coronary perforation was attributable solely to the coronary guidewire in 27 (0.36%) cases. Coronary perforations were divided into 2 types: (1) Those with epicardial staining without a jet of contrast extravasation (type I, n=51), and (2) those with a jet of contrast extravasation (type II, n=18). Patients with type I and type II perforations were managed by observation only (35% and 0%, respectively), reversal of anticoagulation (57% and 94%), pericardiocentesis and drainage (27% and 61%), and prolonged perfusion balloon angioplasty (16% and 100%). Two patients with type II perforations required emergency coronary artery bypass surgery. There were no in-hospital deaths. Late pseudoaneurysms developed in 18 (28.6%) patients during the 13.4±11.3 months' follow-up period, and were more common in patients with type II perforations (72.2% vs 11.1% with type I perforations; p<0.001). During the follow-up period, no patient had evidence of coronary rupture. The results suggest that coronary perforation is uncommon after PCI, and can be managed without cardiac surgery in the majority of cases. Late pseudoaneurysms developed in some patients, particularly in patients with type II perforations, but there were no late consequences of coronary perforation after PCI.
- 社団法人日本循環器学会の論文
- 2002-03-20
著者
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Suzuki Takahiko
Toyohashi Heart Center
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ITOH MAKOTO
The First Department of Internal Medicine, Nagoya City University Medical School
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Fukutomi Tatsuya
Department Of Cardiology Nagoya City University Medical School
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Fukutomi Tatsuya
名古屋市立東市民病院 循環器内科
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Fukutomi Tatsuya
名古屋市立大学 循環器内科
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Ito Shigenori
Division Of Cardiovascular Medicine Toyohashi Heart Center
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Itoh Shigenori
Toyohashi Heart Center
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Ito Shigenori
Toyohashi Heart Center
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Kondo Hiroaki
Department Of Internal Medicine And Bioregulation Nagoya City University Graduate School Of Medical
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Itoh Makoto
Division Of Cardiovascular Medicine National Center For Geriatorics And Gerontology
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Suzuki S
Department Of Cardiology Nagoya City University Medical School
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Hosokawa Hiroaki
National Toyohashi Higashi Hospital
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Fukutomi Tatsuya
The First Department of Internal Medicine, Nagoya City University Medical School
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Popma Jeffrey
Brigham and Women's Hospital, Harvard Medical School
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Yokoya Kouichi
National Toyohashi Higashi Hospital
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Inada Tsuyoshi
Toyohashi Heart Center
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Hayase Motoya
Toyohashi Heart Center
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Kondo Hiroaki
Toyohashi Heart Center
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Suzuki Shogo
The First Department of Internal Medicine, Nagoya City University Medical School
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Suzuki Takahiko
Department Of Cardiology Toyohashi Heart Center
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Itou Makoto
Department Of Internal Medicine And Bioregulation Nagoya City University Graduate School Of Medical
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Suzuki Shogo
The First Department Of Internal Medicine Nagoya City University Medical School
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Popma Jeffrey
Brigham And Women's Hospital Harvard Medical School
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Kondoh Hiroaki
Department Of Internal Medicine And Bioregulation Nagoya City University Graduate School Of Medical
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Suzuki Shogo
Department Of Cardiovascular Medicine National Center For Geriatrics And Gerontology
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Suzuki Takahiko
Division Of Cardiovascular Medicine Toyohashi Heart Center
-
Fukutomi Tatsuya
Department Of Cardiology Nagoya City University
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Itoh Shigenori
Department Of Cardiology Toyohashi Heart Center
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Itou Makoto
Division Of Cardiovascular Medicine National Center For Geriatorics And Gerontology
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Yokoya Kouichi
Dept. Of Cardiology National Toyohashi Higashi Hospital
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Fukutomi Tatsuya
First Department Of Internal Medicine Nagoya City University Medical School
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Itoh Makoto
The Faculty Of Engineering Nagasaki University
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Fukutomi Tatsuya
Department Of Internal Medicine And Pathophysiology Nagoya City University Graduate School Of Medica
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Kondoh Hiroaki
Department Of Internal Medicine And Bioregulation Nagoya City University Graduate School Of Medical
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Suzuki Shogo
First Department Of Internal Medicine Nagoya City University Medical School
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Suzuki Shogo
Division Of Cardiology National Chubu Hospital
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