Lee Michael S, Shamouelian Albert, Dahodwala Mufaddal Q
UCLA Medical Center, 100 Medical Center, Suite 630, Los Angeles, CA 90095 USA.
J Invasive Cardiol. 2016 Mar;28(3):122-31.
Coronary artery perforation (CAP) is a rare but serious complication of percutaneous coronary intervention. Risk factors for CAP include female gender, older age, and lesion complexity. The most common causes of CAP include wire perforation, atherectomy, and aggressive sizing of balloons and stents. Complications of CAP vary greatly from clinical insignificance to hemodynamic collapse and death, depending on the severity of the CAP. Early recognition is of utmost importance to surviving CAP. Generally accepted treatment options depend on lesion severity, and include balloon inflation to tamponade the vessel, reversal of anticoagulation, covered stents, and embolization. Emergent pericardiocentesis or surgical evacuation may be required for the most severe cases.
冠状动脉穿孔（CAP）是经皮冠状动脉介入治疗中一种罕见但严重的并发症。CAP的危险因素包括女性、高龄和病变复杂性。CAP最常见的原因包括导丝穿孔、旋切术以及球囊和支架的过度扩张。CAP的并发症差异很大，从临床无意义到血流动力学崩溃和死亡，这取决于CAP的严重程度。早期识别对于CAP患者的存活至关重要。公认的治疗方案取决于病变严重程度，包括球囊扩张以压迫血管、逆转抗凝、覆膜支架和栓塞。最严重的病例可能需要紧急心包穿刺或手术引流。
