Hussain Sajjad, Kayani Azhar Mahmood, Munir Rubab
Department of Cardiology, Armed Forces Institute of Cardiology - National Institute of Heart Diseases, Rawalpindi.
Department of Obstetrics and Gynaecology, Armed Forces Institute of Cardiology - National Institute of Heart Diseases, Rawalpindi.
J Coll Physicians Surg Pak. 2014 Apr;24(4):290-2.
This study was conducted to determine the frequency and describe the lesion characteristics, clinical factors, device responsible and outcomes for coronary perforations at Armed Forces Institute of Cardiology - National Institute of Heart Diseases (AFIC -NIHD) on all patients undergoing percutaneous coronary interventions (PCI) from 2007 to May 2012. A total of 13,366 PCI procedures were performed during this period; coronary perforation occurred in 16 cases (0.001%). All patients had elective PCI. Fifty percent (n = 8) patients had type C lesions. Grade III perforations were seen in 10 patients. Seven perforations were caused by angiography wires. None of the perforations was related to atherectomy devices. Six patients needed pericardiocentesis. There were 3 in-hospital deaths. One patient needed CABG. At followup, all patients who had been discharged were alive. The frequency of coronary perforations was very low. Old age and type C lesions were identified as a risk factor for coronary perforations. Grade III (or greater) perforation was a predictor of mortality. Patients who are discharged to home generally had better outcomes.
本研究旨在确定2007年至2012年5月期间在武装部队心脏病学研究所-国家心脏病研究所（AFIC-NIHD）对所有接受经皮冠状动脉介入治疗（PCI）的患者发生冠状动脉穿孔的频率，并描述其病变特征、临床因素、相关器械及结局。在此期间共进行了13366例PCI手术；冠状动脉穿孔发生在16例患者中（0.001%）。所有患者均接受择期PCI。50%（n=8）的患者有C型病变。10例患者出现Ⅲ级穿孔。7例穿孔由血管造影导丝引起。所有穿孔均与旋切装置无关。6例患者需要心包穿刺。有3例院内死亡。1例患者需要冠状动脉旁路移植术（CABG）。随访时，所有出院患者均存活。冠状动脉穿孔的频率非常低。高龄和C型病变被确定为冠状动脉穿孔的危险因素。Ⅲ级（或更高）穿孔是死亡率的预测因素。出院回家的患者通常有更好的结局。
