Background: CK-MB levels exceeding 3 times the upper limit of normal (ULN) following percutaneous coronary intervention (PCI), defining periprocedural myocardial infarction (PMI), are associated with worse outcomes. This study assessed the incidence and mechanisms of PMI and their impact on in-hospital stay.
Methods And Results: Over a 12-year period (1996-2007), 272 cases of PMI (overall incidence, 3.5%) were analyzed among 310 consecutive cases of periprocedural myocardial necrosis (PMN; CK-MB > ULN). Mean numbers of treated segments and stents per procedure were 1.87 ± 0.99 and 1.43 ± 1.01, respectively. Mean stent length per procedure was 29.50 ± 19.30 mm. Following analysis of angiogram, procedural data, delay between PCI and necrosis, and mechanisms of PMN were classified as follows: cryptogenic (by exclusion, 41.5%), immediate failure, side-branch occlusion (14.0% each), stent thrombosis (10.6%), prolonged ischemia (9.2%), delayed failure (8.1%), post coronary artery bypass graft (1.5%), and non-target lesion related MI (1.1%). Significantly more stents were used in stent thrombosis, prolonged ischemia during PCI, and cryptogenic cases. In-hospital mortality was 8.1% for PMN and 8.8% for periprocedural MI, decreasing from non-target lesion related MI (25.0%) to mechanisms linked to stent thrombosis (20.7%), immediate failure (17.5%), delayed failure (7.7%), cryptogenic causes (6.1%), and prolonged ischemia (3.4%). Multivariate analysis confirms that in-hospital mortality is influenced by stent thrombosis, age, ejection fraction, and extent of coronary artery disease.
Conclusions: The precise mechanism of PMI was determined in about 60% of our series. Stent thrombosis and immediate failure had the poorest in-hospital outcomes.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Safety of accessing brachial veins for large-bore upper extremity venous thrombectomy using ClotTriever Thrombectomy System.
CVIR Endovasc
January 2025
Department of Radiology, Section of Vascular and Interventional Radiology, University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA.
Purpose: To evaluate access site adverse events following ClotTriever-mediated large-bore mechanical thrombectomy via small upper extremity deep veins (< 6-mm).
Materials And Methods: Twenty patients, including 24 upper extremity venous access sites, underwent ClotTriever-mediated large-bore thrombectomy of the upper extremity and thoracic central veins for symptomatic deep vein obstruction unresponsive to anticoagulation. Patients without follow-up venous duplex examinations (n = 3) were excluded.
The PERFORMANCE II Trial: A Prospective Multicenter Investigation of a Novel Carotid Stent System.
JACC Cardiovasc Interv
December 2024
Department for Angiology, Brandenburg Medical School Theodor Fontane, Campus Clinic Brandenburg, Center for Internal Medicine I, Berlin, Germany; Department of Angiology, Sankt-Gertrauden-Krankenhaus, Berlin, Germany.
Background: Several randomized clinical trials have shown that the composite endpoint of death, stroke, and myocardial infarction (MI) is equivalent between carotid artery stenting and carotid endarterectomy. However, the risk of minor stroke has been consistently higher with carotid artery stenting.
Objectives: The authors sought to evaluate the safety and effectiveness of a novel carotid stent system comprised of a stent, an adjustable integrated embolic filter and a postdilation balloon, in patients at elevated risk for adverse events from carotid endarterectomy.
Platelets, Biomarkers of Coagulation and Fibrinolysis, and Early Coronary Stent Thrombosis.
J Clin Med
December 2024
Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria.
: Acute stent thrombosis (ST) is a rare yet severe complication following percutaneous coronary intervention (PCI). Herein, we investigated the possible association between routinely available coagulation and fibrinolysis markers with early ST. : Within a single-center registry, we investigated the association between the preprocedural platelet count, plasma levels of fibrinogen and D-Dimer, and the incidence of early ST in the first 30 days after PCI.
View Article and Find Full Text PDFCavernous Sinus Syndrome in a Traumatic Dissecting Aneurysm of the Internal Carotid Artery.
Cureus
December 2024
Department of Ophthalmology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, MYS.
We report a rare case of a missed intracavernous internal carotid artery dissecting aneurysm occurring as a complication of the base of skull fracture with severe brain injury causing acute cavernous sinus syndrome with permanent vision loss. A 31-year-old Myanmar lady had an alleged motor vehicle accident and suffered severe traumatic brain injury with multiple intracranial bleeds, multiple facial bone and base of skull fractures, and limb fractures. At one week post-trauma, she had severe right eye proptosis with vision loss, ophthalmoplegia, chemosis, and high intraocular pressure.
View Article and Find Full Text PDFMidterm Results of Fenestrated Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection.
Ann Thorac Surg Short Rep
June 2024
Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Japan.
Background: There is limited experience and knowledge of the use of the fenestrated frozen elephant trunk (FET) technique in acute type A aortic dissection (ATAAD). This study's aims were to assess the clinical outcomes of the fenestrated FET technique for ATAAD and to identify its best practices and pitfalls.
Methods: This study included 101 patients who underwent emergency surgical aortic repair for ATAAD at our hospital between October 2018 and April 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!