PCI complications: distal embolization

Percutaneous coronary intervention Microchapters
Home
Patient Information
Overview
Risk Stratification and Benefits of PCI
Preparation of the Patient for PCI
Equipment Used During PCI
Pharmacotherapy to Support PCI
Vascular Closure Devices
Recommendations for Perioperative Management–Timing of Elective Noncardiac Surgery in Patients Treated With PCI and DAPT
Post-PCI Management
Risk Reduction After PCI
Post-PCI follow up
Hybrid coronary revascularization
PCI approaches
PCI Complications
Factors Associated with Complications Vessel Perforation Dissection Distal Embolization No-reflow Coronary Vasospasm Abrupt Closure Access Site Complications Peri-procedure Bleeding Restenosis Renal Failure Thrombocytopenia Late Acquired Stent Malapposition Loss of Side Branch Multiple Complications
PCI in Specific Patients
Cardiogenic Shock Left Main Coronary Artery Disease Refractory Ventricular Arrhythmia Severely Depressed Ventricular Function Sole Remaining Conduit Unprotected Left Main Patient Adjuncts for High Risk PCI
PCI in Specific Lesion Types
Classification of the Lesion The Calcified Lesion The Ostial Lesion The Angulated or Tortuous Lesion The Bifurcation Lesion The Long Lesion The Bridge Lesion Vasospasm The Chronic Total Occlusion The Left Internal Mammary Artery Multivessel Disease Distal Anastomotic Lesions Left Main Intervention The Thrombotic Lesion
PCI complications: distal embolization On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of PCI complications: distal embolization All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on PCI complications: distal embolization
CDC on PCI complications: distal embolization
PCI complications: distal embolization in the news
Blogs on PCI complications: distal embolization
Directions to Hospitals Treating Percutaneous coronary intervention
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 occlusion of an instrumented vessel or branch due to downstream movement of either thrombus, atheroma, fracture of the distal tip of a coronary guidewire, an undeployed stent or air. 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

• 100% O2, Narcotics, Suction vs hemopump, and Verapamil

References

Template:WikiDoc Sources