CORONARY PERFORATION COMPLICATING ROTATIONAL ABLATION - THE US MULTICENTER EXPERIENCE

This study retrospectively analyzed the data within the U.S. Multicent er Registry for Rotational Ablation to determine the incidence of coro nary perforation during rotational ablation, its angiographic predicto rs and clinical outcomes during 2953 consecutive patients, 3717 lesion s. Patients were categorized into Group A (without perforation, N = 29 31) and Group B (with perforation, N = 22 patients). Perforation occur red in 0.7% of procedures, and in 0.6% of lesions treated and was more frequent within the right (12/1105, 1.1%) and circumflex (9/761, 1.2% ) arteries than the left anterior descending artery [1/1727, 0.06%; (P < 0.001)]. Morphologic features associated with increased perforation rates were eccentricity, tortuousity, and lesion length >10 mm. Group B was assessed with regard to major complications, including death, s urgery, myocardial infarction, or tamponade (type I); and minor compli cations; sealing with balloon angioplasty and without clinical sequela e (type II). There were 15 type I: emergency surgery in nine, of whom two died, and six infarctions (5 non-Q wave and one a wave); and 7 typ e II patients. Coronary perforation, although a rare complication of r otational ablation, is seen more frequently in the right and circumfle x coronary arteries than the left anterior descending artery, and occu rs more frequently with lesion eccentricity, tortuousity, and length > 10 mm. (C) 1996 Wiley-Liss, Inc.