Expecting the unexpected: preventing and managing the consequences of coronary perforations

ABSTRACT

Introduction: Coronary artery perforations are more likely to occur during percutaneous coronary intervention of complex coronary lesions, such as heavily calcified lesions and chronic total occlusions.

Areas covered: Authors provide an update on the management of coronary perforations by performing a critical review of the related, recently published literature.

Expert commentary: Meticulous attention to guidewire position and to device selection is critical for minimizing the risk for coronary perforation. If a perforation occurs, following a structured, algorithmic approach can maximize the likelihood of a successful outcome.

KEYWORDS:

• Perforation
• complex coronary interventions
• percutaneous coronary interventions
• complication
• outcomes

Declaration of interest

ES Brilakis receives consulting/speaker honoraria from Abbott Vascular, ACIST, Amgen, Asahi, CSI, Elsevier, GE Healthcare, Medicure, and Nitiloop; receives research support from Boston Scientific and Osprey; is on the Board of Directors for Cardiovascular Innovations Foundation; and is on the Board of Trustees for Society of Cardiovascular Angiography and Interventions. M Gössl receives consulting honoraria from Atricure. P Sorajja receives consulting honoraria from Abbott Vascular and Medtronic. MN Burke receives consulting and speaker honoraria from Abbott Vascular and Boston Scientific. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.