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coronary artery perforation Complicated With Acute Aortic Valve Regurgitation During Percutaneous coronary Intervention:Report of Two Cases

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Chinese Medical Sciences Journal 2013年第4期28卷 250-253页

作者： Fei Ye Qin Liang Song-hui Luo Li-feng Hong Institute of Cardiovascular Sciences of Jianghan University & the Fifth Hospital of Wuhan

coronary artery perforation catastrophic complication （CAP） is a rare, of percutaneous coronary intervention （PCI）. CAP during PCI procedure is invariably associated with high riskpatients with complex coronary a... 详细信息

关键词： acute aortic valve regurgitation coronary artery perforation percutaneous coronary intervention

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Fatal complication, rescue therapy;covered stent for coronary artery perforation

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Health 2013年第7期5卷 1-5页

作者： Abdulmelik Yildiz Ahmet Karakurt Atila Bitigen Bayram Bagirtan Private Medikalpark Hospital IstanbulTurkey Department of Cardiology Faculty of MedicineKafkas UniversityKarsTurkey Medikal Park Faculty of MedicineKemerburgaz UniversityIstanbulTurkey Private Avrupa Safak Hospital IstanbulTurkey

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 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 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.

关键词： Percutaneous coronary artery Intervention coronary artery perforation Covered Stent

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Clinical outcomes of percutaneous coronary intervention for chronic total occlusion lesions in remote hospitals without on-site surgical support

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Chinese Medical Journal 2009年第19期122卷 2278-2285页

作者： CHEN Shao-liang YE Fei ZHANG Jun-jie LIN Song ZHU Zhong-sheng TIAN Nai-liang LIU Zhi-zhong SUN Xue-wen ZHANG Ai-ping CHEN Feng DING Shi-qin CHEN Jack Department of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu 210006 China Chuzhou Municipal People's Hospital Chuzhou Anhui 239001 China Zhangjiagang Municipal People's Hospital Zhangjiagang Jiangsu 215600 China Huainan Oriental General Hospital Huainan Anhui 232000 China Chaohu 2nd People's Hospital Chaohu Anhui 235056 China Shuyang Municipal Hospital of Traditional Chinese Medicine Shuyang Anhui 257002 China Xuancheng Municipal Hospital Xuancheng Anhui 257089 China Huainan 3rd Mineral Coal General Hospital Huainan Anhui 232000 China Huainan Municipal People's Hospital Huainan Anhni 232000China Wuxi 4th People's Hospital Wuxi Jiangsu 214000 China Huainan Xinhua Hospital Huainan Anhui 232000 China Northside Hospital and Saint Joseph's Translational Research Institute Atlant 40625254 USA

Background The safety of percutaneous coronary intervention （PCI） for chronic total occlusion （CTO） lesions in remote hospitals without surgical facilities remains unknown. This study aimed to evaluate three-year outcomes after CTO for PCI in ten centers around China where no on-site coronary artery bypass grafting （CABG） support was available. Methods A total of 152 patients from 10 Chinese hospitals without on-site surgical facilities were prospectively studied. Intra-procedural and in-hospital events were assessed. Angiographic follow-up was indexed eight months after the initial procedure. Clinical follow-up was extended to three years. The primary outcome was the rate of major adverse cardiac events （MACE）, defined as cardiac death, myocardial infarction and target-vessel revascularization （TVR）. Results The incidence of CTO was 7.9% in patients who underwent PCI, Successful recanalization was achieved in 132 patients （86.8%）. Compared with patients in the PCI success group, patients with PCI procedural failure had longer lesion lengths （（42.32±22.08） mm vs （27.61±22.85） mm, P=0.023）, a higher rate of perforation （25.0% vs 0, P=0.014）, and a greater need for pericardial puncture. There were significant differences in MACE in-hospital and at one year and three years between the failure （10.0%, 30.0% and 35.0%） and the success （3.0%, 12.1% and 14.4%） groups （P=0.037, 0.034 and 0.040, respectively）. These led to a significant decrease in the MACE-free survival rate at one and three years in the failure group, compared with the success group （P=0.031 and 0.023, respectively）. Stump was the only predictor of recanalization success （HR 0.158, 95% Cl 0.041-0.612, P=0.008）, whereas procedural failure （OR 13.023, 95% CI 6.67-13.69, P=0.002）, incomplete revascularization （OR 9.71, 95% CI 2.93-5.59, P=0.005）, and total stent length （OR 6.02, 95% Cl 1.55-11.93, P=0.027） were three independent predictors of MACE. Conclusions PCI for CTO was unsafe in remote hospitals withou

关键词： chronic total occlusion major adverse cardiac events coronary artery perforation

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