Legacy Effect of Coronary Perforation Complicating Percutaneous Coronary Intervention for Chronic Total Occlusive Disease: An Analysis of 26 807 Cases From the British Cardiovascular Intervention Society Database

Circulation. Cardiovascular Interventions
Tim KinnairdBritish Cardiovascular Intervention Society and the National Institute for Cardiovascular Outcomes Research

Abstract

Coronary perforation (CP) during chronic total occlusion percutaneous coronary intervention for stable angina (CTO-PCI) is a rare but serious event. The evidence base is limited, and the long-term effects are unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during CTO-PCI were defined. Data analyzed from the British Cardiovascular Intervention Society data set on all CTO-PCI procedures performed in England and Wales between 2006 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its association with outcomes. A total of 376 CP were recorded from 26 807 CTO-PCI interventions (incidence of 1.40%) with an increase in frequency during the study period (P=0.012). Patient-related factors associated with an increased risk of CP were age and female sex. Procedural factors indicative of complex CTO intervention strongly related to an increased risk of CP with a close relationship between the number of complex strategies used and CP evident (P=0.008 for trend). Tamponade occurred in 16.6% and emergency surgery in 3.4% of cases. Adverse outcomes were frequent in those patients with perforation including bleeding, transfusion, myocardial infarcti...Continue Reading

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Citations

Jan 14, 2018·Journal of the American Heart Association·Peter Tajti, Emmanouil S Brilakis
Feb 16, 2018·Circulation. Cardiovascular Interventions·Chun Shing KwokUNKNOWN British Cardiovascular Intervention Society (BCIS) and National Institute of Cardiovascular Outcomes Research (NICOR)
Aug 8, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Hiroyuki TanakaKazushige Kadota
Dec 10, 2019·Circulation Journal : Official Journal of the Japanese Circulation Society·Jan HarnekBo Lagerqvist
Jul 1, 2020·Expert Review of Cardiovascular Therapy·Ilias NikolakopoulosEmmanouil S Brilakis
Jun 21, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Lorenzo AzzaliniKambis Mashayekhi
Nov 12, 2020·Expert Review of Cardiovascular Therapy·Francesco MoroniLorenzo Azzalini
Nov 18, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Majd B ProttyTim Kinnaird
Jan 14, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Taishi HiraiUNKNOWN OPEN CTO Study Group
Sep 19, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Majd B ProttyTim Kinnaird
Sep 29, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·David E KandzariDimitrios Karmpaliotis

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