Every physician hates to have a patient develop a complication. Nevertheless, we also know that when a problem does develop, one needs a clear corrective strategy to minimize the effect of the complication and thereby prevent a major morbid event. The most frightening of all cardiologic complications occur in the catheterization laboratory. Indeed, Lewis Dexter, one of my mentors, told me about his first, accidental catheterization of the pulmonary artery. When he saw,under the fluoroscope, that the catheter was dancing back and forth in the lung, Dr. Dexter was convinced that he had perforated the patient's heart while trying to thread the catheter through the right atrium to the renal veins. However, after some thought and observation, he realized that he had not encountered a complication; instead he had tripped upon the opportunity to diagnose and understand various forms of heart diseases. Clin ical cardiac catheterization had been born! The 14 chapters in this book have various real-life complications that have occurred during coronary intervention. They also describe various strategies for avoiding or managing them. The chapters take the reader sequentially through a variety of situations, anyone of which would make for a potentially "bad day" in the catheterization laboratory. Starting with medication prob lems,the authors work their wayfrom the groin to the coronary arteries, detail ing unpleasant situations and how to deal with them.
Percutaneous coronary catheterization has become one of the most common medical interventions performed in the field of interventional cardiology. With the continual technical improvements in interventional cardiology, more procedures are being performed and higher risk patients are being treated. Complications are bound to occur, and when they do, they are distressing to the clinician. Too often, clinicians performing an interventional procedure are unprepared and lack complete familiarity with some of the possible adverse events or the many creative methods available to them to reverse or mitigate the event.
This book provides the reader with a valuable overview of the complications associated with coronary interventions. The editor, Samuel M. Butman, MD, has assembled a group of contributors renowned for their expertise in interventional cardiology. Chapters are concise but comprehensive and present actual case examples for review. Topics covered include complications related to medication, coronary guidewires, coronary stenting, atherectomy devices, and radiation exposure. Useful illustrations reinforce key concepts.
Complications of Percutaneous Coronary Interventions fills a void for interventional cardiologists, residents, and technologists who need to learn about effectively preventing complications or who simply want to more confidently institute appropriate treatment.