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array:24 [ "pii" => "S217420491500224X" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.10.011" "estado" => "S300" "fechaPublicacion" => "2015-10-01" "aid" => "689" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:623.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2982 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 2351 "PDF" => 465 ] ] "Traduccion" => array:1 [ "en" => array:20 [ "pii" => "S0870255115002188" "issn" => "08702551" "doi" => "10.1016/j.repc.2015.03.018" "estado" => "S300" "fechaPublicacion" => "2015-10-01" "aid" => "689" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:623.e1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2431 "formatos" => array:3 [ "EPUB" => 176 "HTML" => 1715 "PDF" => 540 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Coronary artery perforation: Don’t rush, IVUS may be useful" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "623.e1" "paginaFinal" => "623.e3" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perfuração da artéria coronária: não se precipite, a ultrassonografia intravenosa pode ser útil" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2483 "Ancho" => 3333 "Tamanyo" => 602542 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(A) Coronary angiography (right anterior oblique view) showing a severe lesion in the mid left anterior descending artery (arrow); (B) underexpanded biolimus-eluting stent (arrow); (C) coronary artery perforation after postdilation with non-compliant balloon; (D) coronary angiography after hemodynamic stabilization showing probable underexpansion of the covered stent (arrows); (D1–4) intravascular ultrasound after postdilation with non-compliant balloon: (D1) segment with a well-expanded covered stent and hematoma outside the lumen; (D2 and 3) segment with two layers of stent (covered stent and biolimus-eluting stent); (D4) segment with a biolimus-eluting stent only.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alfonso Jurado-Román, Julio García-Tejada, Felipe Hernández-Hernández, Carolina Granda-Nistal, María Teresa Velázquez-Martín, Agustín Albarrán González-Trevilla, Juan Tascón-Pérez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Jurado-Román" ] 1 => array:2 [ "nombre" => "Julio" "apellidos" => "García-Tejada" ] 2 => array:2 [ "nombre" => "Felipe" "apellidos" => "Hernández-Hernández" ] 3 => array:2 [ "nombre" => "Carolina" "apellidos" => "Granda-Nistal" ] 4 => array:2 [ "nombre" => "María Teresa" "apellidos" => "Velázquez-Martín" ] 5 => array:2 [ "nombre" => "Agustín Albarrán" "apellidos" => "González-Trevilla" ] 6 => array:2 [ "nombre" => "Juan" "apellidos" => "Tascón-Pérez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S217420491500224X" "doi" => "10.1016/j.repce.2015.10.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491500224X?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002188?idApp=UINPBA00004E" "url" => "/08702551/0000003400000010/v1_201510211302/S0870255115002188/v1_201510211302/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2174204915002251" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.10.012" "estado" => "S300" "fechaPublicacion" => "2015-10-01" "aid" => "687" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2015;34:625-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2317 "formatos" => array:3 [ "EPUB" => 151 "HTML" => 1713 "PDF" => 453 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Looking into and beyond the heart" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "625" "paginaFinal" => "626" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "A olhar para e para além do coração" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1064 "Ancho" => 2169 "Tamanyo" => 180034 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Air-fluid level at the level of the cardiac silhouette (A) and behind the heart (B). Also seen are dual-chamber pacemaker generator and leads (B, arrows) and 26<span class="elsevierStyleHsp" style=""></span>mm Edwards<span class="elsevierStyleSup">®</span> biological aortic valve (B, arrowhead).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Isabel Azevedo, Ricardo Fontes-Carvalho, Adelaide Dias, Vasco Gama Ribeiro" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana Isabel" "apellidos" => "Azevedo" ] 1 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Fontes-Carvalho" ] 2 => array:2 [ "nombre" => "Adelaide" "apellidos" => "Dias" ] 3 => array:2 [ "nombre" => "Vasco" "apellidos" => "Gama Ribeiro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255115002164" "doi" => "10.1016/j.repc.2015.04.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115002164?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915002251?idApp=UINPBA00004E" "url" => "/21742049/0000003400000010/v2_201703210134/S2174204915002251/v2_201703210134/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2174204915002238" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.10.010" "estado" => "S300" "fechaPublicacion" => "2015-10-01" "aid" => "685" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Rev Port Cardiol. 2015;34:621.e1-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2881 "formatos" => array:3 [ "EPUB" => 173 "HTML" => 2274 "PDF" => 434 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "A 75-year-old woman with chest pain and transient severe left ventricular systolic dysfunction" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "621.e1" "paginaFinal" => "621.e8" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Mulher de 75 anos com dor torácica e disfunção sistólica ventricular esquerda grave transitória" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1507 "Ancho" => 3038 "Tamanyo" => 296922 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Coronary angiography. A 40% luminal stenosis with no evidence of plaque rupture or thrombus was observed in the left anterior descending artery. The circumflex and right coronary arteries were normal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jennifer Mancio, Daniel Caeiro, Rita Faria, Miguel Marques, Sofia Bernardino, Marco Oliveira, Aníbal Albuquerque, Vasco Gama Ribeiro" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Jennifer" "apellidos" => "Mancio" ] 1 => array:2 [ "nombre" => "Daniel" "apellidos" => "Caeiro" ] 2 => array:2 [ "nombre" => "Rita" "apellidos" => "Faria" ] 3 => array:2 [ "nombre" => "Miguel" "apellidos" => "Marques" ] 4 => array:2 [ "nombre" => "Sofia" "apellidos" => "Bernardino" ] 5 => array:2 [ "nombre" => "Marco" "apellidos" => "Oliveira" ] 6 => array:2 [ "nombre" => "Aníbal" "apellidos" => "Albuquerque" ] 7 => array:2 [ "nombre" => "Vasco" "apellidos" => "Gama Ribeiro" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915002238?idApp=UINPBA00004E" "url" => "/21742049/0000003400000010/v2_201703210134/S2174204915002238/v2_201703210134/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Coronary artery perforation: Don’t rush, IVUS may be useful" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "623.e1" "paginaFinal" => "623.e3" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alfonso Jurado-Román, Julio García-Tejada, Felipe Hernández-Hernández, Carolina Granda-Nistal, María Teresa Velázquez-Martín, Agustín Albarrán González-Trevilla, Juan Tascón-Pérez" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Alfonso" "apellidos" => "Jurado-Román" "email" => array:1 [ 0 => "alfonsojuradoroman@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Julio" "apellidos" => "García-Tejada" ] 2 => array:2 [ "nombre" => "Felipe" "apellidos" => "Hernández-Hernández" ] 3 => array:2 [ "nombre" => "Carolina" "apellidos" => "Granda-Nistal" ] 4 => array:2 [ "nombre" => "María Teresa" "apellidos" => "Velázquez-Martín" ] 5 => array:2 [ "nombre" => "Agustín Albarrán" "apellidos" => "González-Trevilla" ] 6 => array:2 [ "nombre" => "Juan" "apellidos" => "Tascón-Pérez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Interventional Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Perfuração da artéria coronária: não se precipite, a ultrassonografia intravenosa pode ser útil" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2483 "Ancho" => 3334 "Tamanyo" => 585543 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(A) Coronary angiography (right anterior oblique view) showing a severe lesion in the mid left anterior descending artery (arrow); (B) underexpanded biolimus-eluting stent (arrow); (C) coronary artery perforation after postdilation with non-compliant balloon; (D) coronary angiography after hemodynamic stabilization showing probable underexpansion of the covered stent (arrows); (D1–4) intravascular ultrasound after postdilation with non-compliant balloon: (D1) segment with a well-expanded covered stent and hematoma outside the lumen; (D2 and 3) segment with two layers of stent (covered stent and biolimus-eluting stent); (D4) segment with a biolimus-eluting stent only.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0070" class="elsevierStylePara elsevierViewall">A 69-year-old patient was admitted for unstable angina. The initial ECG showed negative anterior T waves. Physical examination and laboratory tests were normal.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Forty-eight hours later, coronary angiography (CA) was performed. A severe lesion was observed in the mid left anterior descending artery (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A, arrow). A biolimus-eluting stent (3 mm×18 mm; 20 atm) was implanted, angiographic underexpansion being observed (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B, arrow). Postdilatation with a non-compliant balloon (3 mm×15 mm; 22 atm) was performed. Immediately, the patient suffered intense chest pain and a coronary artery perforation (CAP) was observed at the proximal edge of the stent (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C). Bivalirudin was stopped, prolonged balloon inflation proximal to the perforation was performed and a covered stent (2.5 mm×18 mm) was implanted. The patient suffered tamponade and cardiac arrest which required emergent pericardiocentesis and cardiac resuscitation. After stabilization a new CA showed probable underexpansion of the covered stent (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D, arrows). Postdilatation with a non-compliant balloon was performed (3 mm×15 mm; 22 atm), and intravascular ultrasound (IVUS) confirmed correct expansion (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D, 1–4; Video 1). The patient was promptly extubated and discharged. We performed a clinical follow-up, and more than one year later, he remains asymptomatic with no adverse events.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">CAP is a rare (0.43%)<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> but potentially fatal complication of percutaneous coronary intervention. The most reproducible risk factors are oversizing of devices (balloons or stents), female gender, advanced age, atheroablative devices, and treatment of complex lesions.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a> Morbidity and mortality vary directly with Ellis classification: tamponade and mortality rates range between 0.4% and 0.3% (Ellis class I) to 45.7% and 21.2% (Ellis class III), respectively.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The poor prognosis associated with severe CAP emphasizes the importance of taking measures to prevent this complication. Awareness of risk factors, careful guidewire selection, and avoidance of balloon overexpansion remain the mainstays of CAP prevention.</p><p id="par0025" class="elsevierStylePara elsevierViewall">There is no uniform treatment for CAP. A variety of major management strategies, based on little evidence, have been used, including observation, heparin reversal, platelet transfusion, prolonged balloon inflation, covered stent implantation, distal embolization, pericardiocentesis, and surgery.1 Continuous monitoring is essential since deterioration can occur up to 24–48 hours afterwards. Echocardiography studies should be performed serially.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Polytetrafluoroethylene-covered stents prevent blood leakage between stent struts, and a high rate of success has been reported. However, they have some limitations: they lack elasticity and rapid and correct deployment in calcified arteries, in which the majority of perforations occur, can be difficult.1 In addition, higher rates of stent restenosis and thrombosis have been described compared with bare-metal stents and drug-eluting stents, and they also have higher rates of adverse events in long-term follow-up.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">After stabilizing the patient, we should not rush, because, in cases like ours, intracoronary imaging techniques such as IVUS may be useful to ensure correct expansion and reduce further adverse events.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Protection of human and animal subjects</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Confidentiality of data</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Right to privacy and informed consent</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:3 [ "identificador" => "xres817850" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec814957" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres817851" "titulo" => "Resumo" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec814956" "titulo" => "Palavras-chave" ] 4 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 5 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-12-30" "fechaAceptado" => "2015-03-10" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec814957" "palabras" => array:3 [ 0 => "Coronary artery perforation" 1 => "Covered stents" 2 => "Intravascular ultrasound" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec814956" "palabras" => array:3 [ 0 => "Perfuração da artéria coronária" 1 => "<span class="elsevierStyleItalic">Stents</span> revestidos" 2 => "Ultrassonografia intravenosa" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronary artery perforation (CAP) is a rare but potentially fatal complication of percutaneous coronary intervention. Polytetrafluoroethylene-covered stents prevent blood leakage between struts with a high rate of success. However, they lack elasticity and rapid and correct deployment is difficult. They have also a higher rate of stent restenosis and thrombosis. For these reasons, optimal deployment is essential.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Although severe CAP needs an emergent solution, after stabilizing the patient, intracoronary imaging techniques may be useful to ensure correct expansion and reduce further adverse events.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We present a case that shows the potential role of intravascular ultrasound in the resolution of a CAP.</p></span>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A perfuração da artéria coronária (PAC) é uma complicação rara, mas potencialmente fatal da intervenção coronária percutânea (ICP). Os <span class="elsevierStyleItalic">stents</span> revestidos com politetrafluoroetileno impedem o <span class="elsevierStyleItalic">leakage</span> do sangue entre os suportes com uma elevada taxa de sucesso. No entanto, a falta de elasticidade e o posicionamento rápido e correto são difíceis. Apresentam também uma taxa mais elevada de reestenose de <span class="elsevierStyleItalic">stent</span> e de trombose. Por este motivo, é fundamental um posicionamento otimizado.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Embora a PAC necessite de uma solução emergente, após estabilizar o doente, as técnicas intracoronárias imageológicas podem ser úteis para assegurar a expansão correta e reduzir eventos adversos adicionais.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Apresentamos um caso que revela o papel potencial da ultrassonografia intravenosa na resolução de uma PAC.</p></span>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0065" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2483 "Ancho" => 3334 "Tamanyo" => 585543 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">(A) Coronary angiography (right anterior oblique view) showing a severe lesion in the mid left anterior descending artery (arrow); (B) underexpanded biolimus-eluting stent (arrow); (C) coronary artery perforation after postdilation with non-compliant balloon; (D) coronary angiography after hemodynamic stabilization showing probable underexpansion of the covered stent (arrows); (D1–4) intravascular ultrasound after postdilation with non-compliant balloon: (D1) segment with a well-expanded covered stent and hematoma outside the lumen; (D2 and 3) segment with two layers of stent (covered stent and biolimus-eluting stent); (D4) segment with a biolimus-eluting stent only.</p>" ] ] 1 => array:7 [ "identificador" => "upi0005" "etiqueta" => "Video 1" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 9209991 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Pullback of intravascular ultrasound after postdilation of covered stent showing the hematoma outside the lumen and the good final result of the angioplasty, with three segments in the mid left anterior descending artery: a proximal segment with a covered stent (D1), a second segment with two stent layers (covered stent and biolimus-eluting stent) (D2 and 3), and a third segment with a biolimus-eluting stent only (D4).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary perforation in the drug-eluting stent era: incidence, risk factors, management and outcome: the UK experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Hendry" 1 => "D. Fraser" 2 => "J. Eichhofer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4244/EIJV8I1A13" "Revista" => array:6 [ "tituloSerie" => "Eurointervention" "fecha" => "2012" "volumen" => "8" "paginaInicial" => "79" "paginaFinal" => "86" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22580251" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence, predictors, management, immediate and long-term outcomes following grade III coronary perforation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Al-Lamee" 1 => "A. Ielasi" 2 => "A. Latib" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcin.2010.08.026" "Revista" => array:6 [ "tituloSerie" => "JACC Cardiovasc Interv" "fecha" => "2011" "volumen" => "4" "paginaInicial" => "87" "paginaFinal" => "95" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21251634" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased coronary perforation in the new device era. Incidence, classification, management, and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.G. Ellis" 1 => "S. Ajluni" 2 => "A.Z. Arnold" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "1994" "volumen" => "90" "paginaInicial" => "2725" "paginaFinal" => "2730" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7994814" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003400000010/v2_201703210134/S217420491500224X/v2_201703210134/en/main.assets" "Apartado" => array:4 [ "identificador" => "9919" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000010/v2_201703210134/S217420491500224X/v2_201703210134/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491500224X?idApp=UINPBA00004E" ]
Year/Month | Html | Total | |
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2024 November | 7 | 5 | 12 |
2024 October | 34 | 26 | 60 |
2024 September | 46 | 20 | 66 |
2024 August | 34 | 29 | 63 |
2024 July | 39 | 21 | 60 |
2024 June | 36 | 25 | 61 |
2024 May | 39 | 24 | 63 |
2024 April | 31 | 22 | 53 |
2024 March | 36 | 23 | 59 |
2024 February | 31 | 44 | 75 |
2024 January | 24 | 37 | 61 |
2023 December | 24 | 27 | 51 |
2023 November | 31 | 19 | 50 |
2023 October | 34 | 16 | 50 |
2023 September | 29 | 18 | 47 |
2023 August | 33 | 18 | 51 |
2023 July | 30 | 15 | 45 |
2023 June | 34 | 12 | 46 |
2023 May | 51 | 16 | 67 |
2023 April | 28 | 4 | 32 |
2023 March | 31 | 23 | 54 |
2023 February | 37 | 23 | 60 |
2023 January | 25 | 13 | 38 |
2022 December | 36 | 19 | 55 |
2022 November | 41 | 21 | 62 |
2022 October | 48 | 17 | 65 |
2022 September | 24 | 19 | 43 |
2022 August | 32 | 32 | 64 |
2022 July | 39 | 23 | 62 |
2022 June | 27 | 20 | 47 |
2022 May | 28 | 31 | 59 |
2022 April | 41 | 24 | 65 |
2022 March | 41 | 29 | 70 |
2022 February | 42 | 15 | 57 |
2022 January | 68 | 17 | 85 |
2021 December | 50 | 32 | 82 |
2021 November | 58 | 30 | 88 |
2021 October | 61 | 45 | 106 |
2021 September | 58 | 27 | 85 |
2021 August | 68 | 27 | 95 |
2021 July | 52 | 28 | 80 |
2021 June | 48 | 25 | 73 |
2021 May | 46 | 29 | 75 |
2021 April | 71 | 41 | 112 |
2021 March | 62 | 11 | 73 |
2021 February | 63 | 18 | 81 |
2021 January | 27 | 10 | 37 |
2020 December | 38 | 6 | 44 |
2020 November | 45 | 16 | 61 |
2020 October | 32 | 7 | 39 |
2020 September | 61 | 18 | 79 |
2020 August | 41 | 9 | 50 |
2020 July | 79 | 15 | 94 |
2020 June | 55 | 6 | 61 |
2020 May | 60 | 3 | 63 |
2020 April | 62 | 20 | 82 |
2020 March | 40 | 7 | 47 |
2020 February | 141 | 47 | 188 |
2020 January | 55 | 5 | 60 |
2019 December | 74 | 5 | 79 |
2019 November | 59 | 5 | 64 |
2019 October | 73 | 14 | 87 |
2019 September | 66 | 8 | 74 |
2019 August | 65 | 4 | 69 |
2019 July | 40 | 7 | 47 |
2019 June | 41 | 13 | 54 |
2019 May | 43 | 10 | 53 |
2019 April | 60 | 17 | 77 |
2019 March | 112 | 12 | 124 |
2019 February | 70 | 10 | 80 |
2019 January | 53 | 9 | 62 |
2018 December | 62 | 8 | 70 |
2018 November | 103 | 11 | 114 |
2018 October | 147 | 11 | 158 |
2018 September | 53 | 10 | 63 |
2018 August | 35 | 5 | 40 |
2018 July | 32 | 4 | 36 |
2018 June | 40 | 6 | 46 |
2018 May | 51 | 7 | 58 |
2018 April | 49 | 7 | 56 |
2018 March | 60 | 6 | 66 |
2018 February | 31 | 2 | 33 |
2018 January | 38 | 11 | 49 |
2017 December | 44 | 14 | 58 |
2017 November | 15 | 10 | 25 |
2017 October | 18 | 13 | 31 |
2017 September | 17 | 6 | 23 |
2017 August | 14 | 9 | 23 |
2017 July | 18 | 12 | 30 |
2017 June | 24 | 8 | 32 |
2017 May | 32 | 2 | 34 |
2017 April | 30 | 3 | 33 |
2017 March | 35 | 13 | 48 |
2017 February | 45 | 7 | 52 |
2017 January | 40 | 2 | 42 |
2016 December | 47 | 10 | 57 |
2016 November | 39 | 5 | 44 |
2016 October | 57 | 13 | 70 |
2016 September | 53 | 6 | 59 |
2016 August | 15 | 3 | 18 |
2016 July | 20 | 12 | 32 |
2016 June | 11 | 9 | 20 |
2016 May | 21 | 6 | 27 |
2016 April | 9 | 2 | 11 |
2016 March | 18 | 11 | 29 |
2016 February | 22 | 11 | 33 |
2016 January | 27 | 17 | 44 |
2015 December | 13 | 9 | 22 |
2015 November | 32 | 18 | 50 |