Document Detail


Death during percutaneous transluminal coronary angioplasty (PTCA) and the medicolegal aspects.
MedLine Citation:
PMID:  10605073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary embolisation is a very rare complication of the clinically widespread method of percutaneous transluminal coronary angioplasty (PTCA). The well-documented case of a 64-year-old male patient is presented comparing angiographic and morphological findings. The occluded left anterior descending artery (LAD) was successfully dilated during PTCA. Simultaneously the circumflex artery showed acute occlusion. The patient fell into cardiac shock and died after attempted resuscitation and agonal installation of extracorporeal circulation. The autopsy revealed severe residual stenosis of the proximal LAD by parietal thrombosis and occlusion of the proximal circumflex artery by an unattached intraluminal thrombus (0.8 x 0.3 x 0.2 cm) which had been dislocated during PTCA. Autopsy thus confirmed the clinical presumption of coronary embolism and, in addition, disclosed a previously unknown perforation of the femoral artery which had occurred during agonal installation of extracorporeal circulation and contributed to death via severe retroperitoneal hemorrhage. The case is discussed under the aspects of clinical quality control by forensic pathological investigations.
Authors:
W Grellner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Forensic science international     Volume:  105     ISSN:  0379-0738     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-01-11     Completed Date:  2000-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  25-33     Citation Subset:  IM    
Affiliation:
Institute of Forensic Medicine, Saarland University, Homburg, Germany. wolfgang.grellner@med-rz.uni-sb.de
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MeSH Terms
Descriptor/Qualifier:
Angiocardiography
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Autopsy / standards
Coronary Thrombosis / etiology*,  pathology
Coronary Vessels / pathology*
Embolism / etiology*
Fatal Outcome
Femoral Artery / injuries
Humans
Male
Middle Aged
Myocardium / pathology
Quality Assurance, Health Care

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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