We report a 65-year-old man who presented with anastomotic perforation of the distal right coronary artery due to stent deployment, complicated by a small and stable dissecting sub-epicardial hematoma, and non-develop...We report a 65-year-old man who presented with anastomotic perforation of the distal right coronary artery due to stent deployment, complicated by a small and stable dissecting sub-epicardial hematoma, and non-developing stent. The cause was unknown.展开更多
A 56-year-old man with a history of old myocardial infarction and coronary artery bypass grafting was performed percutaneous coronary intervention to the totally occluded lesion of native left anterior descending arte...A 56-year-old man with a history of old myocardial infarction and coronary artery bypass grafting was performed percutaneous coronary intervention to the totally occluded lesion of native left anterior descending artery. He developed a coronary arterial perforation that led to a large dissecting sub-epicardial hematoma. Emergent surgery was performed, and a large hematoma was removed from the sub-epicardial space. Continuous drainage of blood was observed after surgery, and the patient died due to the development of multiorgan dysfunction. An autopsy revealed an extensive sub-epicardial hematoma on the lateral wall of the left ventricle and broad necrosis of the myocardium in the lateral wall.展开更多
Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention. We report a case of type III coronary artery perforation following stenting at calcified mid-segment of left a...Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention. We report a case of type III coronary artery perforation following stenting at calcified mid-segment of left anterior descending artery. The perforation was successfully covered using a PTFE-coated stent with an excellent clinical and angiographic outcomes.展开更多
Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be ...Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20%-0.6%. Its sudden development, the patient’s agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women;the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.展开更多
In order to improve the success rate of chronic total occlusion (CTO)percutaneous coronary intervention (PCI), retrograde approach has been attracted more attention.Recent study reported the collateral perforation rat...In order to improve the success rate of chronic total occlusion (CTO)percutaneous coronary intervention (PCI), retrograde approach has been attracted more attention.Recent study reported the collateral perforation rate was 6.9% in retrograde CTO PCI.[1,2] Collateral related perforations were higher in patients with the epicardial collateral than that with the septal collateral.[3]Several techniques have been developed to deal with the collateral branch perforation.Here,we described the treatment of epicardial collateral branch perforation by absorbable suture segments embolization through microcatheter during retrograde CTO PCI.展开更多
文摘We report a 65-year-old man who presented with anastomotic perforation of the distal right coronary artery due to stent deployment, complicated by a small and stable dissecting sub-epicardial hematoma, and non-developing stent. The cause was unknown.
文摘A 56-year-old man with a history of old myocardial infarction and coronary artery bypass grafting was performed percutaneous coronary intervention to the totally occluded lesion of native left anterior descending artery. He developed a coronary arterial perforation that led to a large dissecting sub-epicardial hematoma. Emergent surgery was performed, and a large hematoma was removed from the sub-epicardial space. Continuous drainage of blood was observed after surgery, and the patient died due to the development of multiorgan dysfunction. An autopsy revealed an extensive sub-epicardial hematoma on the lateral wall of the left ventricle and broad necrosis of the myocardium in the lateral wall.
文摘Coronary artery perforation is a rare but catastrophic complication of percutaneous coronary intervention. We report a case of type III coronary artery perforation following stenting at calcified mid-segment of left anterior descending artery. The perforation was successfully covered using a PTFE-coated stent with an excellent clinical and angiographic outcomes.
文摘Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20%-0.6%. Its sudden development, the patient’s agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women;the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.
文摘In order to improve the success rate of chronic total occlusion (CTO)percutaneous coronary intervention (PCI), retrograde approach has been attracted more attention.Recent study reported the collateral perforation rate was 6.9% in retrograde CTO PCI.[1,2] Collateral related perforations were higher in patients with the epicardial collateral than that with the septal collateral.[3]Several techniques have been developed to deal with the collateral branch perforation.Here,we described the treatment of epicardial collateral branch perforation by absorbable suture segments embolization through microcatheter during retrograde CTO PCI.
