RT Book, Section
A1 Margolis, James R.
A2 Samady, Habib
A2 Fearon, William F.
A2 Yeung, Alan C.
A2 King III, Spencer B.
SR Print(0)
ID 1146606154
T1 Coronary Artery Perforation
T2 Interventional Cardiology, 2e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071820363
LK accesscardiology.mhmedical.com/content.aspx?aid=1146606154
RD 2024/04/25
AB In  the  stent  era,  coronary  artery  perforation  (CAP)  is  the  most  serious  complication  and  a  leading  cause  of  death  from  percutaneous  coronary  intervention  (PCI).  Although  preventable  to  a  great  extent,  perforations  are  inevitable  in  any  high-volume  center.  Prompt  recognition  and  treatment  can  make  the  difference  between  benign  and  fatal  outcomes.  The  incidence  of  CAP  varies  with  the  complexity  of  disease  under  treatment  and  with  the  aggressiveness  of  individual  operators.  An  operator  who  never  experiences  a  perforation  is  probably  underdilating  lesions  and  underdeploying  stents.  The  reported  incidence  varies  from  0.2%  to  0.6%.1-5  It  is  much  higher  when  atheroablative  devices  are  used.5  In  a  meta-analysis  of  nearly  200,000  PCIs,  the  pooled  incidence  was  0.43%.4  Although  there  is  no  good  series  reporting  the  effect  of  stenting  on  the  incidence  of  perforation,  routine  stenting  most  likely  increases  the  perforation  rate.