Making Emergency Artery Repairs Safer

A new study has found that state-of-the-art treatment is making the repair of catheter-related vessel puncture and ruptures during angioplasty less risky.

Researchers from the University of California Davis Medical Center (UCDMC, USA) conducted a review of literature on vessel rupture and perforation: important complications of percutaneous treatment of coronary and peripheral arterial disease. The researchers stressed that these complications could result in abrupt vessel closure, distal organ injury, bleeding into the surrounding tissue, and death. The researchers found that an estimated 0.1% of patients undergoing balloon angioplasty suffered a perforation during the procedure; patients treated with a rotablator drill had a 1.3% risk of perforation, while those treated with the excimer laser faced a 1.9% risk.

Prompt management of such complications is critically important. The review describes the management of vessel rupture and perforation, including the use of different types of covered stents (balloon-expandable and self-expanding), as well as the various types of embolization coils. Following a puncture, the researchers first recommend inflating a balloon at the site to stem the bleeding. Then they suggest inserting embolization coils or a flexible stent graft to repair the vessel. Suggested treatment also involves subsequent drug therapy to promote clotting. The review was published on November 13, 2007, as an online early article in the Journal of Interventional Cardiology.

"Rupture or perforation of a blood vessel during angioplasty can result in life-threatening bleeding,” said lead author John R. Laird, M.D., of the division of cardiovascular medicine at UCDMC. "This review provides doctors with a summary of equipment and techniques that will enhance their ability to treat such complications.”


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University of California Davis Medical Center