Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, NO 180, Fenglin Road, Shanghai 200032, China.
Int J Cardiol. 2020 Jan 1;298:18-21. doi: 10.1016/j.ijcard.2019.07.091. Epub 2019 Aug 1.
Coronary perforation is a serious complication in percutaneous coronary intervention (PCI). In this article, we reported the short and long-term outcomes of patients with coronary perforation managed by coil embolization in our center.
We retrospectively analyzed 66 patients who had coronary perforation treated by coil embolization during PCI performed in our center from Oct 2012 to June 2018.
Of sixty-six cases of coronary perforation, twenty-six cases were distal coronary perforation, while 40 cases were collateral perforation. The average coil number used in distal coronary and collateral perforation lesion is 1.8 ± 0.9 and 1.8 ± 1.0, respectively. The maximum number of coils implanted in each patient is 4 in both groups. Two emergency cardiac surgery to seal the perforation was performed after coil embolization in distal coronary perforation and pericardiocentesis. In collateral perforation, one case of CABG was performed due to myocardial ischemia caused by CTO lesion. During a follow-up of 707 ± 476 days, one patient in collateral perforation group had CABG one month later, while no death or myocardial infarction (MI) was detected. Fifty-four (81.2%) cases of perforations occurred while treating chronic total occlusion, and 74.0% of these perforations were located in collateral vessels, mostly epicardial vessels. Thirty-nine CTO cases (72.2%) were revascularized successfully with the aid of coil embolization.
Coil embolization is feasible and effective in treating distal coronary perforation and collateral perforation during PCI procedure. In CTO lesions, coil embolization facilitates the success of revascularization by PCI.
冠状动脉穿孔是经皮冠状动脉介入治疗（PCI）的严重并发症。本文报道了我们中心采用线圈栓塞治疗冠状动脉穿孔患者的短期和长期结果。
我们回顾性分析了 2012 年 10 月至 2018 年 6 月期间在我院接受 PCI 治疗的 66 例冠状动脉穿孔患者。
在 66 例冠状动脉穿孔患者中，26 例为远端冠状动脉穿孔，40 例为侧支穿孔。远端冠状动脉和侧支穿孔病变使用的平均线圈数分别为 1.8±0.9 和 1.8±1.0。两组患者每个患者植入的最大线圈数均为 4。2 例远端冠状动脉穿孔患者在 coil 栓塞后行紧急心脏手术封堵穿孔，1 例行心包穿刺。在侧支穿孔患者中，1 例 CTO 病变引起心肌缺血行 CABG。在 707±476 天的随访中，1 例侧支穿孔患者在 coil 栓塞后 1 个月行 CABG，无死亡或心肌梗死（MI）。54 例（81.2%）穿孔发生在治疗慢性完全闭塞时，74.0%的穿孔位于侧支血管，多为心外膜血管。39 例 CTO 患者（72.2%）在 coil 栓塞的辅助下成功进行血运重建。
coil 栓塞术治疗 PCI 过程中远端冠状动脉穿孔和侧支穿孔是可行和有效的。在 CTO 病变中， coil 栓塞有助于 PCI 血运重建的成功。
