Coronary artery perforation(CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the pe...Coronary artery perforation(CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the perforation of large vessels involves the placement of a covered stent, while the perforation of distal and collateral vessels is typically managed using coils, autologous skin, subcutaneous fat, microspheres, gelatin sponge, thrombin or other substances. However, the above techniques have certain limitations and are not applicable in all scenarios. Our team has developed a range of innovative strategies for effectively managing CAP. This article provides an insightful review of the various tips and tricks for the treatment of CAP.展开更多
Coronary artery perforation(CAP)remains an infrequent but potentially lifethreatening complication during percutaneous coronary intervention(PCI).Although the prevalence of CAP is about 0.2%−0.9%in relatively low risk...Coronary artery perforation(CAP)remains an infrequent but potentially lifethreatening complication during percutaneous coronary intervention(PCI).Although the prevalence of CAP is about 0.2%−0.9%in relatively low risk PCI,the incidence could up to 9%in complex clinical scenarios such as severe coronary calcification,chronic total occlusions and rotational atherectomy.[1]Despite the new techniques and equipment had lower morbidity and mortality,up to 17%of acute CAP cases would evolve to tamponade and subsequent death.展开更多
Background： Previous studies revealed that culprit vessels of ST-segment elevation myocardial infarction （STEMI） were often related to mild or moderate stenosis. However, recent studies suggested that severe stenos...Background： Previous studies revealed that culprit vessels of ST-segment elevation myocardial infarction （STEMI） were often related to mild or moderate stenosis. However, recent studies suggested that severe stenosis was primarily found in culprit lesions. The objective of this study was to analyze the stenosis severity of culprit lesions in STEMI patients and to clarity the paradoxical results. Methods： A total of 489 consecutive STEMI patients who underwent primary percutaneous coronary intervention were retrospectively studied from January 2012 to December 2014. The patients were divided into three groups based on stenosis severity using quantitative coronary analysis： Group A, 314 cases, stenosis 〉70%： Group B, 127 cases, stenosis 50-70%： and Group C, 48 cases, stenosis 〈_50%,. The clinical, demographic, and angiographic data of all groups were analyzed. Results： Patients in Group A exhibited a significantly higher prevalence of history of angina pectoris （95.9% vs. 62.5%, P 〈 0.001 ）, inultivessel disease （73.2% vs. 54.2%, P = 0.007）, and lower cardiac ejection ITaction （53.3 ± 8.6 vs. 56.8 ± 8.4, P = 0.009） than those in Group C. Multivariable analysis revealed that history of angina pectoris （odds ratio [OR]： 13.89, 95% confidence interval [（7]： 6.21-31.11 ） and multivessel disease （OR： 2.32, 95%, CI： 1.25-4.31 ） were correlated with severe stenosis of the culprit lesion in Group A. Conclusions： Most culprit lesions in STEM[ patients were severe stenosis. These patients exhibited a higher prevalence of angina history and multivessel diseases.展开更多
文摘Coronary artery perforation(CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the perforation of large vessels involves the placement of a covered stent, while the perforation of distal and collateral vessels is typically managed using coils, autologous skin, subcutaneous fat, microspheres, gelatin sponge, thrombin or other substances. However, the above techniques have certain limitations and are not applicable in all scenarios. Our team has developed a range of innovative strategies for effectively managing CAP. This article provides an insightful review of the various tips and tricks for the treatment of CAP.
文摘Coronary artery perforation(CAP)remains an infrequent but potentially lifethreatening complication during percutaneous coronary intervention(PCI).Although the prevalence of CAP is about 0.2%−0.9%in relatively low risk PCI,the incidence could up to 9%in complex clinical scenarios such as severe coronary calcification,chronic total occlusions and rotational atherectomy.[1]Despite the new techniques and equipment had lower morbidity and mortality,up to 17%of acute CAP cases would evolve to tamponade and subsequent death.
文摘Background： Previous studies revealed that culprit vessels of ST-segment elevation myocardial infarction （STEMI） were often related to mild or moderate stenosis. However, recent studies suggested that severe stenosis was primarily found in culprit lesions. The objective of this study was to analyze the stenosis severity of culprit lesions in STEMI patients and to clarity the paradoxical results. Methods： A total of 489 consecutive STEMI patients who underwent primary percutaneous coronary intervention were retrospectively studied from January 2012 to December 2014. The patients were divided into three groups based on stenosis severity using quantitative coronary analysis： Group A, 314 cases, stenosis 〉70%： Group B, 127 cases, stenosis 50-70%： and Group C, 48 cases, stenosis 〈_50%,. The clinical, demographic, and angiographic data of all groups were analyzed. Results： Patients in Group A exhibited a significantly higher prevalence of history of angina pectoris （95.9% vs. 62.5%, P 〈 0.001 ）, inultivessel disease （73.2% vs. 54.2%, P = 0.007）, and lower cardiac ejection ITaction （53.3 ± 8.6 vs. 56.8 ± 8.4, P = 0.009） than those in Group C. Multivariable analysis revealed that history of angina pectoris （odds ratio [OR]： 13.89, 95% confidence interval [（7]： 6.21-31.11 ） and multivessel disease （OR： 2.32, 95%, CI： 1.25-4.31 ） were correlated with severe stenosis of the culprit lesion in Group A. Conclusions： Most culprit lesions in STEM[ patients were severe stenosis. These patients exhibited a higher prevalence of angina history and multivessel diseases.
