000			03432nam a22005177a 4500
008			150313s20142014 xxu||||| |||| 00| 0 eng d
022			_a1569-5794
040			_aOvid MEDLINE(R)
099			_a24728727
245			_aIntravascular ultrasound evidence of perivascular trauma during routine percutaneous coronary intervention.
251			_aThe International Journal of Cardiovascular Imaging. 30(5):849-56, 2014 Jun.
252			_aInt J Cardiovasc Imaging. 30(5):849-56, 2014 Jun.
253			_aThe international journal of cardiovascular imaging
260			_c2014
260			_fFY2014
266			_d2015-03-17
520			_aWe assessed whether intravascular ultrasound (IVUS) can detect evidence of coronary perforation that is not visible by coronary angiography. Approximately 15, 000 consecutive percutaneous coronary interventions (PCI) performed with IVUS guidance were reviewed retrospectively, pre- and post-PCI IVUS images were compared, and IVUS findings were compared with coronary angiography and in-hospital outcomes. We detected three distinct patterns that were not present pre-PCI and that were suggestive of perforation or perivascular trauma: perivascular blood speckle in 67 % (51/76), perivascular hematoma in 17 % (13/76), and new echolucent perivascular layer in 16 % (12/76). Angiographic appearance included perforation in 24 % (18/76), dissection in 33 % (25/76), lumen irregularity in 17 % (13/76), new stenosis in 5 % (4/76), and no abnormalities in 21 % (16/76). The site of a break in arterial wall with communication between the lumen and perivascular space could be detected in 61 % (46/76). This extended proximally and distally with equal frequency, but was primarily located within the lesion in 80 % (61/76), although the lumen was rarely compromised. Within 24 h, there were four emergent coronary artery bypass grafting procedures, one repeat PCI, and six periprocedural myocardial infarctions (defined as CK-MB >10 times the upper limit of normal), but there were no episodes of cardiac tamponade. Although infrequent, IVUS detected three distinct patterns of post-PCI perivascular trauma suggestive of a perforation that was detected angiographically in only 24 % of cases.
546			_aEnglish
650			_a*Percutaneous Coronary Intervention/ae [Adverse Effects]
650			_a*Ultrasonography, Interventional
650			_a*Vascular System Injuries/et [Etiology]
650			_a*Vascular System Injuries/us [Ultrasonography]
650			_aCardiovascular Diseases/su [Surgery]
650			_aCoronary Angiography
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aRetrospective Studies
650			_aTreatment Outcome
650			_aVascular System Injuries/ra [Radiography]
651			_aMedStar Heart & Vascular Institute
657			_aComparative Study
657			_aJournal Article
657			_aResearch Support, Non-U.S. Gov't
700			_aBui, Anh B
700			_aKent, Kenneth M
700			_aPichard, Augusto D
700			_aSatler, Lowell F
700			_aSuddath, William O
700			_aWaksman, Ron
700			_aWeissman, Neil J
790			_aBui AB, Kent KM, Maehara A, Mintz GS, Pichard AD, Satler LF, Suddath WO, Waksman R, Weissman NJ
856			_uhttp://dx.doi.org/10.1007/s10554-014-0413-0 _zhttp://dx.doi.org/10.1007/s10554-014-0413-0
942			_cART _dArticle
999			_c1117 _d1117