“Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention”
Aims: To study the incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) at a high volume center in South-east Asia. Methods: Data from patients who had CAP during PCI from January 2016 to De...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-07-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S001948322030170X |
| _version_ | 1818732428451119104 |
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| author | Chetana Krishnegowda Beeresha Puttegowda Santhosh Krishnappa Rajiv Ananthakrishna Nagesh C. Mahadevappa Sadananda K. Siddegowda Raghu T. Ramegowda Cholenahally N. Manjunath |
| author_facet | Chetana Krishnegowda Beeresha Puttegowda Santhosh Krishnappa Rajiv Ananthakrishna Nagesh C. Mahadevappa Sadananda K. Siddegowda Raghu T. Ramegowda Cholenahally N. Manjunath |
| author_sort | Chetana Krishnegowda |
| collection | DOAJ |
| description | Aims: To study the incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) at a high volume center in South-east Asia. Methods: Data from patients who had CAP during PCI from January 2016 to December 2019 at our center were collected. Clinical features, angiographic and procedural characteristics, their management and outcomes were analyzed retrospectively. Results: A total of 40,696 patients underwent PCI during the study period and the incidence of CAP was 0.13% (n = 51). Mean age was 60.0 ± 10.8 years and 69% were males. CAP cases involved complex type B2/C lesions in 73%, calcified lesions in 58%, and chronic total occlusions in 25%. Majority of patients presented as acute coronary syndrome (65%) and STEMI was the most frequent indication for PCI (33%). Most of the CAPs were Ellis type II (33%) and III (55%). CAP most frequently occurred during post dilation (n = 20) and wire manipulation (n = 17). Majority were treated by prolonged balloon inflation (53%) and covered stents (33%). Pericardiocentesis was required in 19 patients to alleviate tamponade. In one patient coil embolisation was done and two patients required bail-out emergency cardiac surgery. Periprocedural myocardial infarction occurred in 6% and in-hospital mortality was 10%. All-cause mortality accrued to 14% at 30 days and 16% at 6 months. Conclusion: Although incidence of CAP in contemporary interventional practice remains low, the morbidity and mortality are considerable. Early recognition and management strategies tailored to the severity of perforation play a key role in achieving better outcomes. |
| first_indexed | 2024-12-17T23:33:25Z |
| format | Article |
| id | doaj.art-4fb23b4b26e64a18a29032af0864a3b9 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-17T23:33:25Z |
| publishDate | 2020-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-4fb23b4b26e64a18a29032af0864a3b92022-12-21T21:28:36ZengElsevierIndian Heart Journal0019-48322020-07-01724232238“Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention”Chetana Krishnegowda0Beeresha Puttegowda1Santhosh Krishnappa2Rajiv Ananthakrishna3Nagesh C. Mahadevappa4Sadananda K. Siddegowda5Raghu T. Ramegowda6Cholenahally N. Manjunath7Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore Branch, India; Corresponding author. Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore Branch, KRS Road, Kumbara Koppalu, Mysore, 570016, India.Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore Branch, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysore Branch, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaDepartment of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, IndiaAims: To study the incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) at a high volume center in South-east Asia. Methods: Data from patients who had CAP during PCI from January 2016 to December 2019 at our center were collected. Clinical features, angiographic and procedural characteristics, their management and outcomes were analyzed retrospectively. Results: A total of 40,696 patients underwent PCI during the study period and the incidence of CAP was 0.13% (n = 51). Mean age was 60.0 ± 10.8 years and 69% were males. CAP cases involved complex type B2/C lesions in 73%, calcified lesions in 58%, and chronic total occlusions in 25%. Majority of patients presented as acute coronary syndrome (65%) and STEMI was the most frequent indication for PCI (33%). Most of the CAPs were Ellis type II (33%) and III (55%). CAP most frequently occurred during post dilation (n = 20) and wire manipulation (n = 17). Majority were treated by prolonged balloon inflation (53%) and covered stents (33%). Pericardiocentesis was required in 19 patients to alleviate tamponade. In one patient coil embolisation was done and two patients required bail-out emergency cardiac surgery. Periprocedural myocardial infarction occurred in 6% and in-hospital mortality was 10%. All-cause mortality accrued to 14% at 30 days and 16% at 6 months. Conclusion: Although incidence of CAP in contemporary interventional practice remains low, the morbidity and mortality are considerable. Early recognition and management strategies tailored to the severity of perforation play a key role in achieving better outcomes.http://www.sciencedirect.com/science/article/pii/S001948322030170XCardiac tamponadeCoronary artery perforationCovered stentPercutaneous coronary interventionsPericardiocentesis |
| spellingShingle | Chetana Krishnegowda Beeresha Puttegowda Santhosh Krishnappa Rajiv Ananthakrishna Nagesh C. Mahadevappa Sadananda K. Siddegowda Raghu T. Ramegowda Cholenahally N. Manjunath “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” Indian Heart Journal Cardiac tamponade Coronary artery perforation Covered stent Percutaneous coronary interventions Pericardiocentesis |
| title | “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” |
| title_full | “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” |
| title_fullStr | “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” |
| title_full_unstemmed | “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” |
| title_short | “Incidence, clinical and angiographic characteristics, management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention” |
| title_sort | incidence clinical and angiographic characteristics management and outcomes of coronary artery perforation at a high volume cardiac care center during percutaneous coronary intervention |
| topic | Cardiac tamponade Coronary artery perforation Covered stent Percutaneous coronary interventions Pericardiocentesis |
| url | http://www.sciencedirect.com/science/article/pii/S001948322030170X |
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