Guttmann, OP;
Jones, DA;
Gulati, A;
Kotecha, T;
Fayed, H;
Patel, D;
Crake, T;
... O'Mahony, C; + view all
(2017)
Prevalence and outcomes of coronary artery perforation during percutaneous coronary intervention.
EuroIntervention
, 13
(5)
pp. 595-601.
10.4244/EIJ-D-16-01038.
![[thumbnail of Kotecha_Prevalence and outcomes of coronary artery perforation during percutaneous coronary intervention_VoR.pdf]](https://discovery.ucl.ac.uk/style/images/fileicons/text.png) |
Text
Kotecha_Prevalence and outcomes of coronary artery perforation during percutaneous coronary intervention_VoR.pdf - Published Version Access restricted to UCL open access staff Download (629kB) |
Abstract
AIMS: We aimed to examine the prevalence, clinical outcomes and procedural characteristics of percutaneous coronary intervention (PCI) complicated by coronary artery perforation (CAP) in a contemporary patient population. METHODS AND RESULTS: Procedural records of 39,115 patients undergoing PCI between 2005 and 2016 were reviewed. CAP affected 149 cases (0.37%). The prevalence of CAP increased from 0.31% in 2005 to 0.45% in 2016 (p=0.03), reflecting an increase in more complex PCI (from 14% in 2005 to 21% in 2016; p<0.0001). CAP was associated with increased all-cause mortality (23.1% vs. 9.4% in those without perforation; p=0.0054) and was an independent predictor of mortality (HR 2.55; 95% CI: 1.34-4.78). In-patient mortality was 4% (6/149). In 43 of 149 (28.9%) cases, a significant pericardial effusion ensued and mortality rates were higher in this subgroup. Thirty-one patients had covered stents (CS) inserted and five did not survive to discharge. Of the 26 patients with a CS who survived to hospital discharge, six (23.1%) had definite stent thrombosis, and two (7.7%) had possible/probable stent thrombosis. CONCLUSIONS: CAP remains uncommon but the prevalence is increasing. CAP is associated with significant short- and long-term mortality, particularly when there is haemodynamic compromise necessitating pericardiocentesis. Covered stents are a valuable tool but they are associated with a high risk of stent thrombosis.
| Type: | Article |
|---|---|
| Title: | Prevalence and outcomes of coronary artery perforation during percutaneous coronary intervention |
| DOI: | 10.4244/EIJ-D-16-01038 |
| Publisher version: | http://doi.org/10.4244/EIJ-D-16-01038 |
| Language: | English |
| Additional information: | This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10073334 |
Archive Staff Only
 |
View Item |
