Fatal complication, rescue therapy; covered stent for coronary artery perforation ()
Affiliation(s)
Department of Cardiology, Faculty of Medicine, Kafkas University, Kars, Turkey.
Medikal Park, Faculty of Medicine, Kemerburgaz University, Istanbul, Turkey;.
Private Avrupa Safak Hospital, Istanbul, Turkey.
Private Medikalpark Hospital, Istanbul, Turkey.
ABSTRACT
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.
Share and Cite:
Yıldız, A. , Karakurt, A. , Bitigen, A. and Bağırtan, B. (2013) Fatal complication, rescue therapy; covered stent for coronary artery perforation.
Health,
5, 1-5. doi:
10.4236/health.2013.57A3001.