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Delayed perforation after percutaneous coronary intervention: Rare and potentially lethal
Author(s) -
Stathopoulos Ioannis A.,
Kossidas Konstantinos,
Garratt Kirk N.
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25121
Subject(s) - medicine , pericardiocentesis , conventional pci , cardiac tamponade , complication , percutaneous coronary intervention , tamponade , psychological intervention , percutaneous , perforation , surgery , intensive care medicine , cardiology , myocardial infarction , punching , materials science , psychiatry , metallurgy
Cardiac tamponade is a grave but fortunately uncommon complication of percutaneous coronary intervention (PCI). Few studies have specifically addressed angiographic characteristics and outcomes associated with delayed cardiac tamponade after PCI. With the current study we tried to define the incidence of this complication and to characterize the events in order to improve our understanding of the likely mechanisms. Methods/Results We reviewed 23,399 PCIs performed at our institution during an 8‐year period (1999–2006) and we present 10 cases of delayed tamponade. A brief description of each case is provided and findings from retrospective review of the coronary angiography, as well as features of PCI complexity are presented. Also, we summarize the procedural characteristics and outcomes. Delayed perforations are rare and possibly preventable. They usually occur after complex interventions and mostly attributed to distal wire perforations. Surgical intervention is needed less often today than before. Successful pericardiocentesis is of paramount importance. Conclusions The potential lethal outcome associated with delayed tamponade emphasizes the importance of taking steps to prevent this complication. First, prevention and, second, prompt treatment should be the goal, with the use of appropriate technique, clinical awareness, and vigilance. © 2013 Wiley Periodicals, Inc.