Multi-Center Experience of Coronary Artery Perforation during Percutaneous Coronary Intervention: Clinical and Angiographic Characteristics, Management, and Outcomes between 2010 and 2020
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Date
2022
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Abstract
Background: Coronary artery perforations are one of the most feared, rare, and catastrophic complication of percutaneous coronary intervention. Despite the remarkable increase in coronary angiography and percutaneous coronary intervention, there is no large database that collects coronary artery perforation for the Turkish population. Our study aimed to report our experience over a 10-year period for clinical and angiographic characteristics, management strategies, and outcomes of coronary artery perforation during the percutaneous coronary intervention at different cardiology departments in Turkey. Methods: The study data came from a retrospective analysis of 48 360 percutaneous coronary intervention procedures between January 2010 and June 2020. A total of 110 cases who had coronary artery perforation during the percutaneous coronary intervention were found by angiographic review. Analysis has been performed for the basic clinical, angiographic, procedural characteristics, the management of coronary artery perforation, and outcome of all patients. Results: The coronary artery perforation rate was 0.22%. Out of 110 patients with coronary artery perforation, 66 patients showed indications for percutaneous coronary intervention with acute coronary syndrome and 44 patients with stable angina pectoris. The most common lesion type and perforated artery were type C (34.5%) and left anterior descending (41.8%), respectively. The most observed coronary artery perforation according to Ellis classification was type III (37.2%). Almost 52.7% of patients have a covered stent implanted in the perforated artery. The all-cause mortality rate of coronary artery perforation patients in the hospital was 18.1%. Conclusion: The observed rate of coronary artery perforation in our study is consistent with the studies in this literature. However, the mortality rates related to coronary artery perforation are higher than in other studies in this literature. Especially, the in-hospital mortality rate was higher in type II and type III groups due to perforation and its complications. Nevertheless, percutaneous coronary intervention should be done in selected patients despite catastrophic complications. Copyright@Author(s) - Available online at anatoljcardiol.com.
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Keywords
Coronary Angiography , Coronary Artery Disease , Coronary Vessels , Heart Injuries , Humans , Percutaneous Coronary Intervention , Retrospective Studies , Stents , Treatment Outcome , Vascular System Injuries , acetylsalicylic acid , angiotensin receptor antagonist , beta adrenergic receptor blocking agent , biochemical marker , calcium channel blocking agent , clopidogrel , creatine kinase , dipeptidyl carboxypeptidase inhibitor , hydroxymethylglutaryl coenzyme A reductase inhibitor , ivabradine , nitrate , prasugrel , protamine sulfate , trimetazidine , troponin I , acute coronary syndrome , aged , angina pectoris , angiography , artery lesion , Article , body mass , calcification , chronic total occlusion , classification , clinical outcome , controlled study , coronary angiography , coronary artery , coronary artery bypass graft , coronary artery perforation , diabetes mellitus , disease severity assessment , echocardiography , electrocardiogram , electronic medical record , Ellis classification , evidence based practice , extravasation , heart infarction , heart tamponade , human , hypertension , International Classification of Diseases , major clinical study , management , medical record , mortality rate , multicenter study , non ST segment elevation myocardial infarction , paradoxical pulse , percutaneous coronary intervention , pericardial effusion , physician , randomized controlled trial , risk factor , ST segment elevation myocardial infarction , systolic blood pressure , adverse device effect , adverse event , blood vessel injury , coronary artery disease , coronary blood vessel , diagnostic imaging , heart injury , retrospective study , stent , treatment outcome