دورية أكاديمية
أعرض في EDS

Incidence, Treatment, and Outcomes of Coronary Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention.

التفاصيل البيبلوغرافية
العنوان: Incidence, Treatment, and Outcomes of Coronary Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention.
المؤلفون: Danek BA; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Karatasakis A; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Tajti P; Minneapolis Heart Institute, Minneapolis, Minnesota., Sandoval Y; Minneapolis Heart Institute, Minneapolis, Minnesota., Karmpaliotis D; Columbia University, New York, New York., Alaswad K; Henry Ford Hospital, Detroit, Michigan., Jaffer F; Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts., Yeh RW; Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts., Kandzari DE; Piedmont Heart Institute, Atlanta, Georgia., Lembo NJ; Piedmont Heart Institute, Atlanta, Georgia., Patel MP; VA San Diego Healthcare System/University of California San Diego, San Diego, California., Mahmud E; VA San Diego Healthcare System/University of California San Diego, San Diego, California., Choi JW; Baylor Heart and Vascular Hospital, Dallas, Texas., Doing AH; Medical Center of the Rockies, Loveland, Colorado., Lombardi WL; PeaceHealth St. Joseph Medical Center, Bellingham, Washington., Wyman RM; Torrance Memorial Medical Center, Torrance, California., Toma C; University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Garcia S; Minneapolis VA Medical Center, Minneapolis, Minnesota., Moses JW; Columbia University, New York, New York., Kirtane AJ; Columbia University, New York, New York., Hatem R; Columbia University, New York, New York., Ali ZA; Columbia University, New York, New York., Parikh M; Columbia University, New York, New York., Karacsonyi J; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Rangan BV; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Khalili H; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Burke MN; Minneapolis Heart Institute, Minneapolis, Minnesota., Banerjee S; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas., Brilakis ES; VA North Texas Healthcare System/UT Southwestern Medical Center, Dallas, Texas; Minneapolis Heart Institute, Minneapolis, Minnesota. Electronic address: esbrilakis@gmail.com.
المصدر: The American journal of cardiology [Am J Cardiol] 2017 Oct 15; Vol. 120 (8), pp. 1285-1292. Date of Electronic Publication: 2017 Jul 24.
نوع المنشور: Clinical Trial; Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Excerpta Medica
مواضيع طبية MeSH: Intraoperative Complications* , Registries*, Coronary Occlusion/*surgery , Coronary Vessels/*injuries , Percutaneous Coronary Intervention/*adverse effects , Vascular System Injuries/*epidemiology, Aged ; Chronic Disease ; Coronary Angiography ; Coronary Occlusion/diagnosis ; Coronary Vessels/diagnostic imaging ; Female ; Humans ; Incidence ; Japan/epidemiology ; Male ; Odds Ratio ; Risk Factors ; Rupture ; Time Factors ; Treatment Outcome ; United States/epidemiology ; Vascular System Injuries/diagnosis ; Vascular System Injuries/therapy
مستخلص: Coronary perforation is a potential complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We analyzed 2,097 CTO PCIs performed in 2,049 patients from 2012 to 2017. Patient age was 65 ± 10 years, 85% were men, and 36% had prior coronary artery bypass graft surgery. Technical and procedural success were 88% and 87%, respectively. A major periprocedural adverse cardiovascular event occurred in 2.6%. Coronary perforation occurred in 85 patients (4.1%); The frequency of Ellis class 1, 2, and 3 perforations was 21%, 26%, and 52%, respectively. Perforation occurred more frequently in older patients and those with previous coronary artery bypass graft surgery (61% vs 35%, p < 0.001). Cases with perforation were angiographically more complex (Multicenter CTO Registry in Japan score 3.0 ± 1.2 vs 2.5 ± 1.3, p < 0.001). Twelve patients (14%) with perforation experienced tamponade requiring pericardiocentesis. Patient age, previous PCI, right coronary artery target CTO, blunt or no stump, use of antegrade dissection re-entry, and the retrograde approach were associated with perforation. Adjusted odds ratio for periprocedural major periprocedural adverse cardiovascular events among patients with perforation was 15.04 (95% confidence interval 7.35 to 30.18). In conclusion, perforation occurs relatively infrequently in contemporary CTO PCI performed by experienced operators and is associated with baseline patient characteristics and angiographic complexity necessitating use of advanced crossing techniques. In most cases, perforations do not result in tamponade requiring pericardiocentesis, but they are associated with reduced technical and procedural success, higher periprocedural major adverse events, and reduced procedural efficiency.
(Published by Elsevier Inc.)
تواريخ الأحداث: Date Created: 20170823 Date Completed: 20171003 Latest Revision: 20171003
رمز التحديث: 20240829
DOI: 10.1016/j.amjcard.2017.07.010
PMID: 28826896
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-1913
DOI:10.1016/j.amjcard.2017.07.010