{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T14:21:49Z","timestamp":1776176509265,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T00:00:00Z","timestamp":1587772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Percutaneous coronary intervention (PCI) is increasingly utilized for treatment of coronary disease involving the unprotected left main stem (ULMS). However, no studies to date have examined the outcomes of such interventions when complicated by coronary perforation (CP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the British Cardiovascular Intervention society (BCIS) database, data were analyzed on all ULMS\u2010PCI procedures complicated by CP in England and Wales between 2007 and 2014. Multivariate logistic regressions were used to identify predictors of ULMS CP and to evaluate the association between this complication and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During 10,373 ULMS\u2010PCI procedures, CP occurred more frequently than in non\u2010ULMS\u2010PCI (0.9 vs. 0.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) with a stable annual incidence. Covariates associated with CP included number of stents used, female gender, use of rotational atherectomy and chronic total occlusion (CTO) intervention. Adjusted odds of adverse outcomes for ULMS\u2010PCI complicated by CP were higher for peri\u2010procedural complications including cardiogenic shock, tamponade, side\u2010branch loss, DC cardioversion, in\u2010hospital major bleeding, transfusion requirement, and peri\u2010procedural myocardial infarction. There were also significantly increased odds for in\u2010hospital major adverse cardiac events (MACCE, OR 8.961, 95% CI [4.902\u201316.383]) and 30\u2010day mortality (OR 5.301, 95% CI [2.741\u201310.251]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CP is an infrequent event during ULMS\u2010PCI and is predicted by female gender, rotational atherectomy, CTO interventions or number of stents used. CP was associated with significantly higher odds of mortality and morbidity, but at rates similar to previously published all\u2010comer PCI complicated by CP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28933","type":"journal-article","created":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T13:48:40Z","timestamp":1587822520000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of coronary perforation in percutaneous interventions involving the left main stem coronary artery in the United Kingdom 2007\u20132014: Insights from the British Cardiovascular Intervention Society database"],"prefix":"10.1002","volume":"97","author":[{"given":"Hussain I.","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8992-9120","authenticated-orcid":false,"given":"Majd B.","family":"Protty","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"},{"name":"Division of Immunity and Infection Systems Immunity University Research Institute, Cardiff University  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Al\u2010Raisi","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Aldalati","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasim","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew S. P.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"},{"name":"University of Exeter  Exeter Devon UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0582-1628","authenticated-orcid":false,"given":"Richard","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1209-3534","authenticated-orcid":false,"given":"Tim","family":"Kinnaird","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital of Wales  Cardiff UK"},{"name":"Keele Cardiovascular Research Group Institute of Applied Clinical Sciences, University of Keele  Stoke\u2010on\u2010Trent UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.15420\/ICR.2015.10.03.132"},{"key":"e_1_2_7_3_1","first-page":"3","article-title":"NOBLE and EXCEL: the debate for excellence in dealing with left main stenosis","volume":"2018","author":"Kindi HA","year":"2018","journal-title":"Glob Cardiol Sci Pract"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.115.003449"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.01.052"},{"issue":"299","key":"e_1_2_7_6_1","first-page":"37","article-title":"Coronary perforation complicating percutaneous coronary intervention in patients presenting with an acute coronary syndrome: an analysis of 1,013 perforation cases from the British cardiovascular intervention society database","volume":"72","author":"Kinnaird T","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_7_7_1","unstructured":"British Cardiovascular Intervention Society. 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