{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T09:35:04Z","timestamp":1791106504610,"version":"4.1.0"},"reference-count":19,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:p>\n                  <jats:bold>Objective:<\/jats:bold> To examine the clinical outcome of percutaneous coronary intervention where the procedure was complicated by vessel perforation.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Setting:<\/jats:bold> Tertiary referral centre.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods:<\/jats:bold> The procedural records of 6245 patients undergoing coronary intervention were reviewed. In 52 patients (0.8%) the procedure was complicated by vessel perforation, ranging from wire exit to free flow of contrast into the pericardial space. The majority of lesions treated were complex (37% type B, 59% type C) and 9 of 52 (17%) were chronic occlusions. Ten patients (19%) received abciximab. Four underwent rotational atherectomy (8%).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> In 28 of 52 patients (54%) the perforation was benign and managed conservatively without the development of haemodynamically significant sequelae. In 24 of 52 (46%) a significant pericardial effusion ensued requiring drainage. Of these 24 procedures 6 had involved the treatment of a chronic occlusion (25%). Eight of the 24 patients were referred for emergency bypass surgery (33%), 3 of whom died. Of the remaining 16 not referred for surgery, 3 died. Of the 10 procedures complicated by vessel perforation where abciximab had been administered, 9 (90%) led to pericardial tamponade. Latterly 2 vessel perforations were successfully treated by the deployment of a covered stent.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions:<\/jats:bold> Coronary artery perforation with sequelae during intervention is rare\u201426 of 6245 (0.4%). This complication was seen in the treatment of chronic occlusions, which are therefore not risk-free procedures. The development of pericardial tamponade carries a high mortality. While prompt surgical intervention may be life saving, expertise in the use of covered stents may provide a valuable rescue option for this serious complication. Caution should be exercised where coronary perforation occurs and abciximab has been used.<\/jats:p>","DOI":"10.1136\/heart.88.5.495","type":"journal-article","created":{"date-parts":[[2002,10,15]],"date-time":"2002-10-15T14:02:42Z","timestamp":1034690562000},"page":"495-498","source":"Crossref","is-referenced-by-count":129,"title":["Coronary artery perforation during percutaneous intervention: incidence and outcome"],"prefix":"10.1136","volume":"88","author":[{"given":"M G","family":"Gunning","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I L","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D E","family":"Jewitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A M","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Wainwright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M R","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2002,11,1]]},"reference":[{"key":"2025092012404549000_88.5.495.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01053-5"},{"key":"2025092012404549000_88.5.495.2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2000.107996"},{"key":"2025092012404549000_88.5.495.3","first-page":"481","volume":"8","year":"1982","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2025092012404549000_88.5.495.4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/clc.4960090106","volume":"9","year":"1986","journal-title":"Clin Cardiol"},{"key":"2025092012404549000_88.5.495.5","first-page":"284","volume":"27","year":"1992","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2025092012404549000_88.5.495.6","first-page":"177","volume":"23","year":"1991","journal-title":"Cathet Cardiovasc Diagn"},{"key":"2025092012404549000_88.5.495.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)02172-X"},{"key":"2025092012404549000_88.5.495.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00478-0"},{"key":"2025092012404549000_88.5.495.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(96)90069-1"},{"key":"2025092012404549000_88.5.495.10","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/0735-1097(94)90861-3","volume":"24","year":"1994","journal-title":"J Am Coll Cardiol"},{"key":"2025092012404549000_88.5.495.11","unstructured":"National Institute for Clinical Excellence. Guidance on the use of glycoprotein IIb-IIIa inhibitors in the treatment of acute coroanry syndromes. NICE technology appraisal guidance, no 12. London: NICE, 2000."},{"key":"2025092012404549000_88.5.495.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)85010-1"},{"key":"2025092012404549000_88.5.495.13","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.15.1951"},{"key":"2025092012404549000_88.5.495.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)90007-8"},{"key":"2025092012404549000_88.5.495.15","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.4.1757"},{"key":"2025092012404549000_88.5.495.16","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/00019501-199809090-00008","volume":"9","year":"1998","journal-title":"Coron Artery Dis"},{"key":"2025092012404549000_88.5.495.17","first-page":"272","volume":"12","year":"2000","journal-title":"J Invasive Cardiol"},{"key":"2025092012404549000_88.5.495.18","first-page":"622","volume":"11","year":"1999","journal-title":"J Invasive Cardiol"},{"key":"2025092012404549000_88.5.495.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006223422519"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heart.88.5.495","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T19:40:54Z","timestamp":1758397254000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heart.88.5.495"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,11]]},"references-count":19,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2002,11,1]]},"published-print":{"date-parts":[[2002,11]]}},"alternative-id":["10.1136\/heart.88.5.495"],"URL":"https:\/\/doi.org\/10.1136\/heart.88.5.495","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,11]]}}}