CURRENT APPROACHES TO THE PREVENTION, EVALUATION AND TREATMENT OF COMPLICATIONS DURING ENDOVASCULAR CORONARY ARTERY INTERVENTIONS. PART I. CORONARY ARTERY RUPTURES

• Main Author: S. A. Prozorov
• Format: Article
• Language: Russian
• Published: Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department 2016-03-01
• Series: Neotložnaâ Medicinskaâ Pomoŝʹ
• Subjects: coronary artery stenting; complications; coronary artery rupture; stent-grafts; embolization
• Online Access: https://www.jnmp.ru/jour/article/view/185

AIM OF THE STUDY. The aim of the study was to investigate the incidence, causes, predictors, forms of coronary artery ruptures during endovascular interventions, and to present current approaches to rupture treatment.MATERIAL AND METHODS. The results of endovascular procedures performed in 2317 patients from January 2010 to March 2013 were reviewed. Coronary artery ruptures occurred in 5 patients (0.22%).RESULTS. A coronary artery rupture was classified by Ellis criteria as type II in 1 patient and as type III in 4 patients. The vessel wall was perforated with a hydrophilic guidewire in one patient. A rupture occurred during balloon dilatation in 2 patients, and at postdilatation after stent implantation in 2 other patients. The complications were treated using the following techniques: a prolonged balloon inflation, implantation of stent-grafts, embolization. These approaches proved to be effective in 4 of 5 cases, in 1 case a repeated rupture during the stent-graft implantation resulted in a fatal outcome.CONCLUSIONS. The treatment techniques for coronary artery ruptures may be different and the choice should be based on the cause and the form of rupture. Successful treatment of this complication is feasible.