“Cath Lab Catastrophes: Management and Prevention” “Cath Lab ...

Coronary Perforation
PTCA 0.1%, Roto/DCA 0.5 - 2.0%. Stent
0.5%
Wire perforation (3/7000) rare, but may be
slow to be recognized. Often with stiff wire,
hydrophilic wire
If device doesn’t follow, usually benign
Device perforation can be rapidly fatal
May occur hours later
Clinical signs are variable
Treatment: reverse A/C, perfusion balloon,
centesis, covered stents, coils, RH Cath,
serial ECHOs