Document Detail


Successful treatment of distal coronary guidewire-induced perforation with balloon catheter delivery of intracoronary thrombin.
MedLine Citation:
PMID:  12594705     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Distal coronary artery perforation with a coronary guidewire is a relatively rare but potentially fatal complication during PTCA. Historically, these types of perforations have been easy to control with reversal of heparin anticoagulation combined with prolonged distal balloon inflation. In the modern era, with widespread use of potent glycoprotein IIb/IIIa inhibitors, this type of distal wire perforation has become more difficult to manage and potentially lethal. In this article, we report two cases of guidewire-related distal coronary artery perforation, successfully treated using a new technique using localized, distal intracoronary thrombin injection. During prolonged low-pressure balloon inflation, a small dose of thrombin was injected just proximal to the wire perforation site via the lumen of a coronary balloon catheter. This approach appears to be a relatively rapid and effective way to control this troublesome complication.
Authors:
Tim A Fischell; Elie H Korban; Michael A Lauer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  58     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-02-20     Completed Date:  2003-06-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  370-4     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Department of Medicine, Michigan State University, Kalamazoo, Michigan 49048, USA. taf1@net-link.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Balloon Dilatation / methods*
Coronary Angiography
Coronary Vessels / injuries*
Female
Heart Injuries / etiology*,  radiography,  therapy*
Hemostatics / administration & dosage*,  therapeutic use*
Humans
Injections, Intralesional / methods*
Intraoperative Complications*
Male
Thrombin / administration & dosage*,  therapeutic use*
Chemical
Reg. No./Substance:
0/Hemostatics; EC 3.4.21.5/Thrombin

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


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