PCI complications: peri procedure bleeding: Difference between revisions

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Latest revision as of 19:13, 22 January 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Peri-procedure bleeding is one of the most frequent complications of percutaneous coronary interventions, and independent predictor of mortality.^[1]. Although periprocedural bleeding is almost unavoidable clinical complication in coagulopathies, ^[2] manipulation after a careful evaluation of the patient may help to reduce its frequency. ^[3]

Peri-procedure Bleeding

2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)^[4]

Bleeding Risk (DO NOT EDIT)^[4]

Class I
"1. All patients should be evaluated for risk of bleeding before PCI. (Level of Evidence: C)"

References

↑ Ndrepepa G, Berger PB, Mehilli J, Seyfarth M, Neumann FJ, Schömig A, Kastrati A Periprocedural Bleeding and 1-Year Outcome After Percutaneous Coronary Interventions Appropriateness of Including Bleeding as a Component of a Quadruple End Point. J Am Coll Cardiol. 2008 Feb 19;51 (7):690-697 PMID 18279731
↑ Macdonald J, Srinivasan M, More R. Percutaneous Coronary Intervention in a Patient with von Willebrand’s Disease Presenting with an Acute Coronary Syndrome. The Journal of Invasive Cardiology Volume 18 April - Issue 4 - April 2006 - Pages: 174-77
↑ Kong DF, Califf RM, Miller DP, et al. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease. Circulation 1998;98:2829–2835.
↑ ^4.0 ^4.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)

Template:WikiDoc Sources

[1] Ndrepepa G, Berger PB, Mehilli J, Seyfarth M, Neumann FJ, Schömig A, Kastrati A Periprocedural Bleeding and 1-Year Outcome After Percutaneous Coronary Interventions Appropriateness of Including Bleeding as a Component of a Quadruple End Point. J Am Coll Cardiol. 2008 Feb 19;51 (7):690-697 PMID 18279731

[2] Macdonald J, Srinivasan M, More R. Percutaneous Coronary Intervention in a Patient with von Willebrand’s Disease Presenting with an Acute Coronary Syndrome. The Journal of Invasive Cardiology Volume 18 April - Issue 4 - April 2006 - Pages: 174-77

[3] Kong DF, Califf RM, Miller DP, et al. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease. Circulation 1998;98:2829–2835.

[pmid22070837-4] 4.0 ^4.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)

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@@ Line 1: / Line 1: @@
-{{SI}}
+__NOTOC__
+{{PCI}}
 {{CMG}}
+Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.
 ==Overview==
+Peri-procedure [[bleeding]] is one of the most frequent [[complication]]s of percutaneous coronary interventions, and independent predictor of [[mortality]].<ref>Ndrepepa G, Berger PB, Mehilli J, Seyfarth M, Neumann FJ, Schömig A, Kastrati A Periprocedural Bleeding and 1-Year Outcome After Percutaneous Coronary Interventions Appropriateness of Including Bleeding as a Component of a Quadruple End Point. J Am Coll Cardiol. 2008 Feb 19;51 (7):690-697 PMID 18279731</ref>. Although periprocedural [[bleeding]] is almost unavoidable clinical [[complication]] in [[coagulopathy|coagulopathies]], <ref>Macdonald J, Srinivasan M, More R. Percutaneous Coronary Intervention in a Patient with von Willebrand’s Disease Presenting with an Acute Coronary Syndrome. The Journal of Invasive Cardiology Volume 18 April - Issue 4 - April 2006 - Pages: 174-77</ref> manipulation after a careful evaluation of the patient may help to reduce its frequency. <ref>Kong DF, Califf RM, Miller DP, et al. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease. Circulation 1998;98:2829–2835.
-Peri-procedure bleeding is one of the most frequent complications of [[percutaneous coronary intervention]]s, and independent predictor of mortality.<ref>Ndrepepa G, Berger PB, Mehilli J, Seyfarth M, Neumann FJ, Schömig A, Kastrati A Periprocedural Bleeding and 1-Year Outcome After Percutaneous Coronary Interventions Appropriateness of Including Bleeding as a Component of a Quadruple End Point. J Am Coll Cardiol. 2008 Feb 19;51 (7):690-697 PMID 18279731</ref>
-Although periprocedural bleeding is almost unavoidable clinical complication in coagulopathies, <ref>Macdonald J, Srinivasan M, More R. Percutaneous Coronary Intervention in a Patient with von Willebrand’s Disease Presenting with an Acute Coronary Syndrome. The Journal of Invasive Cardiology Volume 18 April - Issue 4 - April 2006 - Pages: 174-77</ref> manipulation after a careful evaluation of the patient may help to reduce its frequency. <ref>Kong DF, Califf RM, Miller DP, et al. Clinical outcomes of therapeutic agents that block the platelet glycoprotein IIb/IIIa integrin in ischemic heart disease. Circulation 1998;98:2829–2835.
 </ref>
+==Peri-procedure Bleeding==
+==2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)<ref name="pmid22070837">{{cite journal|author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]]|volume=58 |issue=24 |pages=2550–83 |year=2011|month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref>==
+===Bleeding Risk (DO NOT EDIT)<ref name="pmid22070837">{{cite journal|author=Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH |title=2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions |journal=[[Journal of the American College of Cardiology]]|volume=58|issue=24 |pages=2550–83|year=2011|month=December|pmid=22070837|doi=10.1016/j.jacc.2011.08.006|url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)02875-0|accessdate=2011-12-08|url=http://content.onlinejacc.org/cgi/reprint/58/24/2550.pdf|PDF}}</ref>===
-==Pathologic Findings==
+{|class="wikitable"
-<br>
-<div align="left">
-<gallery heights=200" widths="200">
-image:image1.png|Complication during [[subclavian vein]] cannulation. Image courtesy of [[C. Michael Gibson]] and copylefted.
-image:image2.png|Normal anatomic position of subclavian vein
-</gallery>
-</div>
-<div align="left">
+|-
-<gallery heights=200" widths="200">
+| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
-image:image3.png|Complication during right femoral artery puncture. Image courtesy of [[C. Michael Gibson]] and copylefted.
+|-
-image:image4.png|Complication during right femoral artery puncture. Image courtesy of [[C. Michael Gibson]] and copylefted.
+| bgcolor="LightGreen"|
-</gallery>
+<nowiki>"</nowiki>'''1.''' All patients should be evaluated for risk of [[bleeding]] before PCI. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki>
-</div>
+|}
-<div align="laft">
-<gallery heights=200" widths="200">
-image:image5.png|Complication of pulling out when there was resistance in a stent graft system. Part of right iliac and femoral arteries stripped with stent graft system from right femoral artery puncture site. Image courtesy of [[C. Michael Gibson]] and copylefted.
-image:Access_Site.png|Higher Level Puncture of Femoral Artery and Cannula Kinking. Image courtesy of [[C. Michael Gibson]] and copylefted.
-</gallery>
-</div>
 ==References==
 {{Reflist|2}}
+[[Category:Up-To-Date]]
+[[Category:Up-To-Date cardiology]]
 [[Category:Cardiology]]
+[[Category:Needs content]]
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