Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients

Objective. Coil embolization (CE) for coronary artery perforation (CAP) has not been thoroughly evaluated. This study aimed to evaluate the extent of myocardial damage and impact on cardiac function after CE for CAP. Methods. A total of 110 consecutive patients treated with CE for CAP were retrospec...

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Autores principales:	Daisuke Hachinohe, Yoshifumi Kashima, Yuito Okada, Daitaro Kanno, Ken Kobayashi, Umihiko Kaneko, Takuro Sugie, Yutaka Tadano, Tomohiko Watanabe, Hidemasa Shitan, Takuya Haraguchi, Yusuke Morita, Nobuki Matsuna, Ryo Horita, Masanaga Tsujimoto, Tsuyoshi Takeuchi, Katsuhiko Sato, Tsutomu Fujita
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi-Wiley 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/a5e1b268598242c29c80defb93457395
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spelling	oai:doaj.org-article:a5e1b268598242c29c80defb934573952021-11-22T01:11:15ZCoil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients1540-818310.1155/2021/9022326https://doaj.org/article/a5e1b268598242c29c80defb934573952021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9022326https://doaj.org/toc/1540-8183Objective. Coil embolization (CE) for coronary artery perforation (CAP) has not been thoroughly evaluated. This study aimed to evaluate the extent of myocardial damage and impact on cardiac function after CE for CAP. Methods. A total of 110 consecutive patients treated with CE for CAP were retrospectively identified. The degree of myocardial damage and impact on cardiac function were evaluated. Results. Forty-nine (44.5%) cases involved chronic total occlusions. A guidewire was the cause of perforation in 97 (88.2%) patients. The success rate of CE was 98.2%. Almost all patients were prescribed either antiplatelet drugs or anticoagulant medication or both. Patients with perforation types III and IV were found to be prone to creatinine kinase (CK) elevation and epicardial main vessel perforation, thereby causing myocardial damage. No changes were noted in the ejection fraction (EF) in patients with type V distal perforation and collateral channel perforation, while patients with perforation of the epicardial main vessel may show impaired cardiac function afterward. Conclusions. CE is safe and effective for treating CAP, especially when collateral channels and distal vessels are involved. Meanwhile, efforts should be taken to prevent CAP in epicardial main vessels since it may be difficult to treat with CS and cause myocardial damage when bailed out with CE leading to vessel sacrifice. We found that it was not necessary to change the anticoagulant regimen after CE owing to its ability to achieve robust hemostasis.Daisuke HachinoheYoshifumi KashimaYuito OkadaDaitaro KannoKen KobayashiUmihiko KanekoTakuro SugieYutaka TadanoTomohiko WatanabeHidemasa ShitanTakuya HaraguchiYusuke MoritaNobuki MatsunaRyo HoritaMasanaga TsujimotoTsuyoshi TakeuchiKatsuhiko SatoTsutomu FujitaHindawi-WileyarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Interventional Cardiology, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Daisuke Hachinohe Yoshifumi Kashima Yuito Okada Daitaro Kanno Ken Kobayashi Umihiko Kaneko Takuro Sugie Yutaka Tadano Tomohiko Watanabe Hidemasa Shitan Takuya Haraguchi Yusuke Morita Nobuki Matsuna Ryo Horita Masanaga Tsujimoto Tsuyoshi Takeuchi Katsuhiko Sato Tsutomu Fujita Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
description	Objective. Coil embolization (CE) for coronary artery perforation (CAP) has not been thoroughly evaluated. This study aimed to evaluate the extent of myocardial damage and impact on cardiac function after CE for CAP. Methods. A total of 110 consecutive patients treated with CE for CAP were retrospectively identified. The degree of myocardial damage and impact on cardiac function were evaluated. Results. Forty-nine (44.5%) cases involved chronic total occlusions. A guidewire was the cause of perforation in 97 (88.2%) patients. The success rate of CE was 98.2%. Almost all patients were prescribed either antiplatelet drugs or anticoagulant medication or both. Patients with perforation types III and IV were found to be prone to creatinine kinase (CK) elevation and epicardial main vessel perforation, thereby causing myocardial damage. No changes were noted in the ejection fraction (EF) in patients with type V distal perforation and collateral channel perforation, while patients with perforation of the epicardial main vessel may show impaired cardiac function afterward. Conclusions. CE is safe and effective for treating CAP, especially when collateral channels and distal vessels are involved. Meanwhile, efforts should be taken to prevent CAP in epicardial main vessels since it may be difficult to treat with CS and cause myocardial damage when bailed out with CE leading to vessel sacrifice. We found that it was not necessary to change the anticoagulant regimen after CE owing to its ability to achieve robust hemostasis.
format	article
author	Daisuke Hachinohe Yoshifumi Kashima Yuito Okada Daitaro Kanno Ken Kobayashi Umihiko Kaneko Takuro Sugie Yutaka Tadano Tomohiko Watanabe Hidemasa Shitan Takuya Haraguchi Yusuke Morita Nobuki Matsuna Ryo Horita Masanaga Tsujimoto Tsuyoshi Takeuchi Katsuhiko Sato Tsutomu Fujita
author_facet	Daisuke Hachinohe Yoshifumi Kashima Yuito Okada Daitaro Kanno Ken Kobayashi Umihiko Kaneko Takuro Sugie Yutaka Tadano Tomohiko Watanabe Hidemasa Shitan Takuya Haraguchi Yusuke Morita Nobuki Matsuna Ryo Horita Masanaga Tsujimoto Tsuyoshi Takeuchi Katsuhiko Sato Tsutomu Fujita
author_sort	Daisuke Hachinohe
title	Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
title_short	Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
title_full	Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
title_fullStr	Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
title_full_unstemmed	Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients
title_sort	coil embolization for coronary artery perforation: a retrospective analysis of 110 patients
publisher	Hindawi-Wiley
publishDate	2021
url	https://doaj.org/article/a5e1b268598242c29c80defb93457395
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Coil Embolization for Coronary Artery Perforation: A Retrospective Analysis of 110 Patients

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