Pericardial Bleeding Following Covered Stent Thrombosis: Sharp Blade on Both Sides

Yıl 2018, Cilt: 2 Sayı: 3, 210 - 214, 13.11.2018

Ali Çoner , Davran Çiçek , Sinan Akıncı , Tonguç Saba Haldun Müderrisoğlu

https://doi.org/10.30565/medalanya.421746

Öz

Advancements in coronary stent technology encourage
interventional Cardiologists in performing more complex, percutaneous
interventions. Coronary perforation is a lethal complication of percutaneous
coronary artery interventions and should be managed within seconds to minutes.
Despite technological advancements, coronary perforation incidence has not
declined over the years. This consistent incidence of coronary perforation may
be related to increased number of complex, percutaneous coronary artery
interventions. Covered stent implantation is a life-saving solution during the
course of this emergent complication but also carries its own short and long
term risks in the follow-up of these patients. Herein this report, we aimed to
present a successful management of a case of coronary perforation by covered
stent implantation but complicated during in-hospital period in the following
days.

Anahtar Kelimeler

Covered Stent Thrombosis, Pericardial Bleeding, Complication

Kaplı Stent Trombozu Sonrası Perikardiyal Kanama: İki Ucu Keskin Bıçak

Öz

Koroner
stent alanındaki teknolojik gelişmeler girişimsel Kardiyologları daha kompleks
perkütan girişimler gerçekleştirme konusunda cesaretlendirmektedir. Koroner
perforasyon perkütan koroner arter girişimleri esnasında görülebilen ölümcül
bir komplikasyondur ve saniyeler veya dakikalar içerisinde müdahale
edilmelidir. Geçen yıllar içerisinde teknolojik gelişmeler olmasına karşın
koroner perforasyon sıklığı azalmamıştır. Koroner perforasyon sıklığında azalma
olmamasının kompleks, perkütan koroner arter girişimlerinde artış görülmesiyle
ilişkisi olabilir. Kaplı stent implantasyonu acilen müdahale edilmesi gereken
bu komplikasyonun seyri sırasında hayat kurtarıcı bir çözümdür ancak bu
hastaların takiplerinde, kısa ve uzun dönemde kendine özgü riskler oluşturmaktadır.
Bu yazıda, kaplı stent implantasyonu ile başarılı müdahale yapılan ancak takip
eden günlerde hastane içi dönemde komplikasyon yaşadığımız bir koroner
perforasyon vakasının sunummayı amaçladık.    

Anahtar Kelimeler

Kaplı stent trombozu, Perikardiyal kanama, Komplikasyon

Kaynakça

• 1 Gruberg L, Pinnow E, Flood R, Bonnet Y, Tebeica M, Waksman R, et al. Incidence, management and outcome of coronary artery perforation during percutaneous coronary intervention. Am J Cardiol. 2000; 86: 680-2.
• 2 Hendry C, Fraser D, Eichhofer J, Mamas MA, Fath-Ordoubadi F, El-Omar M, et al. Coronary perforation in the drug-eluting stent era: incidence, risk factors, management and outcome: the UK experience. Eurointervention. 2012; 15: 79-86.
• 3 Parsh J, Seth M, Green J, Sutton NR, Chetcuti S, Dixon S, et al. Coronary artery perforations after contemporary percutaneous coronary interventions: evaluation of incidence, risk factors, outcomes and predictors of mortality. Catheter Cardiovasc Interv. 2017; 89: 966-73.
• 4 Ellis SG, Ajluni S, Arnold AZ, Popma JJ, Bittl JA, Eigler NL, et al. Increased coronary perforation in the new device era. Incidence, classification, management and outcome. Circulation. 1994; 90: 2725-30.
• 5 Karaman K, Karayakalı M, Arısoy A, Akar İ, Çelik A. A late complication of coronary artery perforation during primary percutaneous coronary intervention: Coronary arteriovenous fistula. Turk Kardiyol Dern Ars. 2017; 45: 739-43.
• 6 Lee MS, Shamouelian A, Dahodwala MQ. Coronary artery perforation following percutaneous coronary intervention. J Invasive Cardiology. 2016; 28: 122-31.
• 7 Al-Lamee R, Ielasi A, Latib A, Godino C, Ferraro M, Mussardo M, et al. Incidence, predictors, management, immediate and long-term outcomes following grade III coronary perforation. JACC Cardiovasc Interv. 2011; 4: 87-95.
• 8 Kawamoto H, Tanaka K, Ruparelia N, Takagi K, Yabushita H, Watanabe Y, et al. Short-term and long-term outcomes after polytetrafluoroethylene-covered stent implantation for treatment of coronary perforation. Am J Cardiol. 2015; 116: 1822-6.
• 9 Lee WC, Hsueh SK, Fang CY, Wu CJ, Hang CL, Fang HY. Clinical outcomes following covered stent for the treatment of coronary artery perforation. J Interv Cardiol. 2016; 29: 569-75.
• 10 Wang HJ, Lin JJ, Lo WY, Chang CP, Hsu CH, Hsieh LJ, et al. Clinical outcomes of polytetrafluoroethylene-covered stents for coronary artery perforation in elderly patients undergoing percutaneous coronary interventions. Acta Cardiol Sin. 2017; 33: 605-13.
• 11 Eeckhout E, De Palma R. Coronary perforation: an inconvenient complication. JACC Cardiovasc Interv. 2011; 4: 96-7.
• 12 Copeland KA, Hopkins JT, Weintraub WS, Rahman E. Long-term follow-up of polytetrafluoroethylene-covered stents implanted during percutaneous coronary intervention for management acute coronary perforation. Catheter Cardiovasc Interv. 2012; 80: 53-7.
• 13 Kolek M. Effusive-constrictive pericarditis post surgical revision for iatrogenic hemo-pericardium. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011;155:71-4.
• 14 Shimony A, Joseph L, Mottillo S, Eisenberg MJ. Coronary artery perforation during percutaneous coronary intervention: a systematic review and meta-analysis. Can J Cardiol. 2011; 27: 843-50.
• 15 Stathopoulos I, Kossidas K, Panagopoulos G, Garratt K. Cardiac tamponade complicating coronary perforation during angioplasty: short-term outcomes and long-term survival. J Invasive Cardiol. 2013; 25: 486-91.
• 16 Fejka M, Dixon SR, Safian RD, O’Neill WW, Grines CL, Finta B, et al. Diagnosis, management, and clinical outcome of cardiac tamponade complicating percutaneous coronary intervention. Am J Cardiol. 2002; 90: 1183-6.
• 17 Huang CM, Chen LW, Huang SH, Huang SS, Wang KL, Chiang CE. Acute left ventricular rupture following posterior wall myocardial infarction. Intern Med. 2010; 49: 1387-90.
• 18 Lin HH, Lai WL, Li PC, Li ML. Aortic perforation as a complication of percutaneous coronary angiography. Formos J Surg. 2011; 44: 225-7.