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Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade: an algorithm for percutaneous management
- Source :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 52(3)
- Publication Year :
- 2001
-
Abstract
- Coronary perforation is an uncommon but potentially life-threatening complication of percutaneous coronary intervention. The use of both atheroablative technologies for coronary intervention and adjunctive platelet glycoprotein blockade pharmacology may increase the incidence of or risk for life-threatening bleeding complications following the occurrence of coronary artery perforation. The interventional database for 6,214 percutaneous coronary interventions performed between January 1995 and June 1999 was analyzed. Hospital charts and cine angiograms for all patients identified in the database as having had coronary perforation were reviewed. Coronary perforation complicated 0.58% of all procedures and was more commonly observed in patients with a history of congestive heart failure and following use of atheroablative interventional technologies (2.8%). There was no association of abciximab therapy with either the incidence of or classification for coronary perforation. Adverse clinical outcomes (death, emergency surgical exploration) were related to the angiographic classification of perforation and were more frequently observed in patients who experienced a class 3 coronary perforation. These data suggest that specific clinical and procedural demographic factors are associated with the occurrence and severity of angiographic coronary perforation. An angiographic perforation class-specific algorithm for treatment of coronary perforation is proposed.
- Subjects :
- Atherectomy, Coronary
Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Abciximab
Perforation (oil well)
Coronary Disease
Hemorrhage
Platelet Glycoprotein GPIIb-IIIa Complex
Coronary Angiography
Angioplasty, Laser
Immunoglobulin Fab Fragments
Risk Factors
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
Angioplasty, Balloon, Coronary
Coronary Artery Perforation
Aged
Retrospective Studies
business.industry
Incidence (epidemiology)
Percutaneous coronary intervention
Antibodies, Monoclonal
General Medicine
Middle Aged
medicine.disease
Coronary Vessels
Surgery
Heart Injuries
Heart failure
Cardiology
Cineangiography
Female
Stents
Cardiology and Cardiovascular Medicine
Complication
business
Algorithm
Algorithms
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 15221946
- Volume :
- 52
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions
- Accession number :
- edsair.doi.dedup.....1f76a37e013763de9fa0c014fc71fae8