PCI complications: distal embolization: Difference between revisions
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==Overview== | ==Overview== | ||
[[Distal]] [[embolization]] during [[percutaneous coronary intervention]] is defined as occlusion of an instrumented | [[Distal]] [[embolization]] during [[percutaneous coronary intervention]] is defined as either partial or complete occlusion of an instrumented major epicardial [[coronary artery]] or a branch due to downstream movement of either [[thrombus]], [[atheroma]], fracture of the [[distal]] tip of a [[coronary guidewire]], an undeployed stent or air.<ref name="pmid8187116">{{cite journal |author=Ishizaka N, Issiki T, Saeki F, Furuta Y, Ikari Y, Yamaguchi T |title=Predictors of myocardial infarction after distal embolization of coronary vessels with percutaneous transluminal coronary angioplasty. Experience of 21 consecutive patients with distal embolization |journal=[[Cardiology]] |volume=84 |issue=4-5 |pages=298–304 |year=1994 |pmid=8187116 |doi= |url= |accessdate=2011-12-28}}</ref> It is manifested clinically as either [[chest pain]], [[ST segment elevation]], [[no reflow]] during the procedure and / or a rise in [[biomarkers]] of [[myonecrosis]] ([[CK-MB]] or [[troponin]]) following the [[PCI]]. | ||
==Causes== | ==Causes== | ||
*[[Thrombus]] | *[[Thrombus]] (from a thrombotic culprit lesion or a [[coronary guidewire]] or other equipment in the [[coronary artery]]) | ||
*[[Atheroma]] | *[[Atheroma]] | ||
*An undeployed stent | *An undeployed stent | ||
| Line 13: | Line 13: | ||
*Air bubbles from manifold injections | *Air bubbles from manifold injections | ||
==Epidemiology and Demographics== | |||
Distal embolization occurs in approximately 10% of patients with an [[acute myocardial infarction]] undergoing PCI. | Distal embolization occurs in approximately 10% of patients with an [[acute myocardial infarction]] undergoing PCI. Embolic complications occur more often in patients with [[acute MI]] and in patients undergoing balloon angioplasty of [[saphenous vein graft]] [[lesion]]s, particularly those with recent [[total occlusion]]. | ||
===Diagnosis=== | ===Diagnosis=== | ||
Latest revision as of 16:43, 3 May 2014
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Percutaneous coronary intervention Microchapters |
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PCI Complications |
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PCI in Specific Patients |
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PCI in Specific Lesion Types |
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PCI complications: distal embolization On the Web |
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American Roentgen Ray Society Images of PCI complications: distal embolization |
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Directions to Hospitals Treating Percutaneous coronary intervention |
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Risk calculators and risk factors for PCI complications: distal embolization |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D., Sapan Patel M.B.B.S
Overview
Distal embolization during percutaneous coronary intervention is defined as either partial or complete occlusion of an instrumented major epicardial coronary artery or a branch due to downstream movement of either thrombus, atheroma, fracture of the distal tip of a coronary guidewire, an undeployed stent or air.[1] It is manifested clinically as either chest pain, ST segment elevation, no reflow during the procedure and / or a rise in biomarkers of myonecrosis (CK-MB or troponin) following the PCI.
Causes
- Thrombus (from a thrombotic culprit lesion or a coronary guidewire or other equipment in the coronary artery)
- Atheroma
- An undeployed stent
- Fracture of the distal tip of a coronary guidewire
- Air bubbles from manifold injections
Epidemiology and Demographics
Distal embolization occurs in approximately 10% of patients with an acute myocardial infarction undergoing PCI. Embolic complications occur more often in patients with acute MI and in patients undergoing balloon angioplasty of saphenous vein graft lesions, particularly those with recent total occlusion.
Diagnosis
Coronary Angiography: Distal Embolization
Treatment
Distal Embolization Examples
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References
- ↑ Ishizaka N, Issiki T, Saeki F, Furuta Y, Ikari Y, Yamaguchi T (1994). "Predictors of myocardial infarction after distal embolization of coronary vessels with percutaneous transluminal coronary angioplasty. Experience of 21 consecutive patients with distal embolization". Cardiology. 84 (4–5): 298–304. PMID 8187116.
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