Document Detail


Dual catheter technique for the treatment of severe coronary artery perforations.
MedLine Citation:
PMID:  20049957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the outcome of patients with coronary perforations who were treated with the dual catheter approach. BACKGROUND: Coronary artery perforation is a grave complication of percutaneous coronary intervention (PCI) with high mortality and morbidity. Treating a coronary artery perforation with two catheters through dual access enables a rapid delivery of covered stent or coils to the vessel, without losing control of the perforation site. METHODS: We retrospectively reviewed all patients who had a severe coronary perforation during a PCI in our center, and compared outcomes of patients treated with the dual versus the traditional single guiding catheter approach. RESULTS: Between April 2004 and October 2008, 13,466 PCI's were performed in Columbia University - New York Presbyterian Medical Center. There were 33 documented cases of coronary perforations during that period of time (0.245%), among these, 26 were angiographically severe (Ellis type 2 or 3 perforations). Eleven patients were treated acutely with a dual catheter technique whereas the other fifteen patients were treated using a single guiding catheter. In the dual catheter group one patient expired after emergent CABG (9.1%), and four patients underwent emergent paricardiocentesis (36.4%). In patients treated with single catheter, there were three deaths (20%), two surgical explorations (13.3%), eight emergent pericardiocenthesis (53.3%), and one event of severe anoxic brain damage (6.7%). CONCLUSION: The dual catheter technique is a relatively safe and reproducible approach to treat a PCI induced severe coronary artery perforation, and may improve outcome compared to historical series.
Authors:
Yanai Ben-Gal; Giora Weisz; Michael B Collins; Philippe Genereux; George D Dangas; Paul S Teirstein; Varinder P Singh; LeRoy E Rabbani; Susheel K Kodali; Warren Sherman; Martin B Leon; Jeffrey W Moses
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  75     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-06-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  708-12     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Affiliation:
Interventional Cardiology, New York Presbyterian Hospital, Columbia University Medical Center, New York 10032, USA. yb2211@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Balloon Occlusion / adverse effects,  instrumentation,  methods*
Coronary Angiography
Coronary Vessels / injuries*
Female
Heart Catheterization / adverse effects,  instrumentation,  methods*
Humans
Iatrogenic Disease*
Male
New York City
Retrospective Studies
Rupture
Severity of Illness Index
Stents
Treatment Outcome
Wounds, Penetrating / etiology,  radiography,  therapy*
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Apr 1;75(5):713-4   [PMID:  20333676 ]

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


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