Tejas Patel, MD | Sanjay Shah, MD | Samir B. Pancholy, MD

Book Excerpts

Foreword

Complication strategies are an integral part of the field of interventional cardiology. There are multiple components to the strategies. They include the identification of patients and lesions in whom increased complication rates may be anticipated. For this group of strategies, great care is required for planning optimal approaches in these complex situations.

Preface

Having worked with, worked on, and worked for ailing hearts most of our lives, we would like to make this book a heart-to-heart talk — simple, straightforward, and substantial. Direct and distinct, without any decoration, confusion, or diversion. Medical reality as it is, without any hype or hue. 

Chapter 1: Complications of PCI: An Overview

Complications are a fact of life in interventional cardiology. The unpredictable nature of the underlying cardiac disease, variations in operator technique and experience, and imperfect tools of interventional cardiology conspire to set the stage for complications. Interventional cardiologists as a group are perfectionist by trade.

Chapter 2: Coronary Artery Perforations

Coronary artery perforation is an infrequent but potentially life-threatening complication during percutaneous coronary intervention (PCI).1-8 It is one of the most challenging complications faced by an interventional cardiologist in the catheterization laboratory and has repeatedly been shown to be associated with poorer outcomes, including myocardial infarction (MI), emergency coro

Chapter 3: Coronary Artery Aneurysms

The incidence of coronary artery aneurysm has been reported in the range of 1.5% to 5%.1-6 Aneurysm formation is defined as a widening of arterial lumen greater than 1.5 times the normal native vessel diameter.

Chapter 4: Coronary and Aortic Root Dissections

In the modern era, as interventional cardiologists continue to treat high-risk patients, coronary dissections continue to occur before and after stent placement.

Chapter 5: Coronary No-Reflow and Air Embolism

Coronary “no-reflow” is a sign of insufficient myocardial perfusion in the absence of flow-limiting epicardial vessel obstruction, dissection, spasm, or distal macro-embolus.1-6 The most efficacious approach to no-reflow is to prevent its occurrence. In this regard, case selection is critical to avoid the possibility of no-reflow.

Chapter 6: Managing Trapped Devices in the Coronary and Peripheral Circulation

Entrapment of a device in the coronary system is one of the most distressing complications of percutaneous coronary intervention (PCI). Due to its rare occurrence, many operators may not be familiar with retrieval techniques and the special hardware potentially available for use.

Chapter 7: Dealing With Rare Complications: Mayo Clinic Experience

Optical Coherence Tomography (OCT) Complications 

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