Acute and long-term outcome after coronary artery perforation during percutaneous coronary interventions

H. Eggebrecht* (Corresponding Author), A. Ritzel, C. Von Birgelen, A. Schermund, C. Naber, D. Böse, D. Baumgart, T. Bartel, M. Haude, R. Erbel

*Corresponding author for this work

    Research output: Contribution to journalReview articleAcademicpeer-review

    13 Citations (Scopus)

    Abstract

    Background: Coronary artery perforation is a rare but serious complication of percutaneous coronary interventions (PCI). Methods: We reviewed our database for cases of overt coronary perforation during PCI procedures. Hospital charts, procedural reports, and coronary angiograms of these patients were reviewed, with particular emphasis on mechanisms of perforation, management of the complication, and clinical outcome. Results: Between 01/1998 and 12/2003, a total of 19 cases (mean age: 66±8 years, 13 male) of coronary perforation occurred during 6433 PCI procedures performed within this period (incidence: 0.3%). In 12/19 (63%) cases, perforation occurred during recanalisation procedures of chronic total occlusions of coronary arteries. In all but one patient, non-surgical management was attempted: 2 out of 19 (11%) patients were treated conservatively by reversal of heparin anticoagulation. Prolonged balloon inflation at the perforation site was applied in 10/19 (53%) patients. Six (32%) patients received stents (5 of them received covered stent-grafts), 3 (16%) patients developed cardiac tamponade requiring percardiocentesis, and only 2 (11%) patients underwent bail-out surgical repair. There were 2 (11%) deaths early after the procedure. Conclusion: Coronary perforation during PCI is a rare complication, but is associated with significant morbidity and mortality. In the majority of patients, non-surgical management is both feasible and associated with a high success-rate.

    Original languageEnglish
    Pages (from-to)791-798
    Number of pages8
    JournalZeitschrift fur Kardiologie
    Volume93
    Issue number10
    DOIs
    Publication statusPublished - 1 Oct 2004

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    Keywords

    • Cardiac tamponade
    • Complication
    • Perforation
    • PTCA
    • Stent-graft

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