Incidence, Mechanisms, Treatment, and Outcomes of Coronary Artery Perforation During Chronic Total Occlusion Percutaneous Coronary Intervention

Coronary artery perforation is a feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Our objective was to describe the incidence, mechanisms, treatment, and outcomes of coronary artery perforation during CTO PCI. We analyzed the baseline clinical and angiog...

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Bibliographic Details
Published in:The American journal of cardiology 2022-11, Vol.182, p.17-24
Main Authors: Kostantinis, Spyridon, Simsek, Bahadir, Karacsonyi, Judit, Alaswad, Khaldoon, Krestyaninov, Oleg, Khelimskii, Dmitrii, Karmpaliotis, Dimitri, Jaffer, Farouc A., Khatri, Jaikirshan J., Poommipanit, Paul, Jaber, Wissam A., Rinfret, Stephane, Nicholson, William, Patel, Mitul P., Mahmud, Ehtisham, Koutouzis, Michael, Tsiafoutis, Ioannis, Benton, Stewart M., Davies, Rhian E., Toma, Catalin, Kerrigan, Jimmy L., Haddad, Elias V., Abi-Rafeh, Nidal, ElGuindy, Ahmed M., Goktekin, Omer, Mastrodemos, Olga C., Rangan, Bavana V., Burke, M. Nicholas, Brilakis, Emmanouil S.
Format: Article
Language:English
Subjects:
Angioplasty
Autografts
Balloon treatment
Calcification
Cardiovascular disease
Coronary artery
Coronary vessels
Dissection
Embolization
Heart attacks
Heart surgery
Hypertension
Implants
Intervention
Mortality
Occlusion
Patients
Perforation
Stents
Success
Tamponade
Trends
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Summary:Coronary artery perforation is a feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Our objective was to describe the incidence, mechanisms, treatment, and outcomes of coronary artery perforation during CTO PCI. We analyzed the baseline clinical and angiographic characteristics and procedural outcomes of 10,454 CTO PCIs performed in 10,219 patients between 2012 and 2022. The incidence of coronary perforation was 4.9% (n = 503). Patients who experienced coronary perforation were older and were more likely to have had previous coronary artery bypass graft surgery. Procedures that resulted in perforation were more complex, with higher Japanese CTO and Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO) scores. Technical (66% vs 87%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2022.07.004