Coronary artery perforation by intracoronary guide wires: risk factors and clinical outcomes.

The aims of this study were to determine the incidence of coronary artery perforation by intracoronary guide wires during angioplasty, to identify associated factors, and to assess outcomes. The retrospective analysis covered 4,353 consecutive procedures, corresponding to a total 6,994 lesions treated over a period of 8 years. Coronary artery perforation by guide wires occurred in 15 cases (0.35%). Perforation was associated with the number of hydrophilic wires used (odds ratio=2.33; 95% confidence interval, 1.34-4.05) and treatment of chronic occlusions (odds ratio=3.31; 95% confidence interval, 1.05-10.46). Cardiac tamponade occurred in seven cases (46.7%), six of which were subacute. Three cases were resolved by pericardiocentesis, while four required surgical drainage. Cardiac tamponade was associated with the number of guide wires used (P=.039) and the use of abciximab (P=.016). No death occurred.

[1]  J. Popma,et al.  Early and late clinical outcomes following coronary perforation in patients undergoing percutaneous coronary intervention. , 2002, Circulation journal : official journal of the Japanese Circulation Society.

[2]  S. Ellis,et al.  Increased Coronary Perforation in the New Device Era: Incidence, Classification, Management, and Outcome , 1994, Circulation.

[3]  A. Roguin,et al.  Coronary perforation 2006--watch for the wire. , 2005, The Journal of invasive cardiology.

[4]  D. Kereiakes,et al.  Coronary perforation during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade: An algorithm for percutaneous management , 2001, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[5]  Charles T. Lau,et al.  Comparison of physician-rated performance characteristics of hydrophilic-coated guide wires. , 2008, Journal of vascular and interventional radiology : JVIR.

[6]  F H Sheehan,et al.  The effect of intravenous thrombolytic therapy on left ventricular function: a report on tissue-type plasminogen activator and streptokinase from the Thrombolysis in Myocardial Infarction (TIMI Phase I) trial. , 1987, Circulation.

[7]  K. Kent,et al.  Management and outcomes of coronary artery perforation during percutaneous coronary intervention. , 2006, The American journal of cardiology.

[8]  Ermengol Vallés,et al.  Perforación coronaria complicada con taponamiento cardíaco sellada mediante coils metálicos , 2004 .

[9]  H. Loeb,et al.  Coronary artery perforation during percutaneous coronary intervention: incidence and outcomes in the new interventional era. , 2005, The Journal of invasive cardiology.

[10]  A. Shah,et al.  Coronary artery perforation during percutaneous intervention: incidence and outcome , 2002, Heart.

[11]  K. Asai,et al.  Coronary perforation during percutaneous coronary intervention. , 2007, International heart journal.

[12]  I. Palacios,et al.  The changing pattern of coronary perforation during percutaneous coronary intervention in the new device era. , 2004, The Journal of invasive cardiology.

[13]  W. O’Neill,et al.  Diagnosis, management, and clinical outcome of cardiac tamponade complicating percutaneous coronary intervention. , 2002, The American journal of cardiology.

[14]  Alfonso Medina,et al.  Intervencionismo percutáneo. ¿Dónde estamos y adónde vamos? , 2005 .

[15]  F. Loop,et al.  Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). , 1988, Circulation.

[16]  G. P. Miralda,et al.  Orientación diagnóstica y manejo de los síndromes pericárdicos agudos , 2005 .