https://www.stcccv.org.tn/web/app_dev123.php/QuizCasdemois/38/reponse

Method
GET
HTTP Status
200
IP
54.36.148.37
Profiled on
Sun, 25 May 2025 05:29:02 +0200
Token
ab3826

QuizcasdemoisController :: ReponseAction

Request

GET Parameters

No GET parameters

POST Parameters

No POST parameters

Request Attributes

Key Value
Quiz 
Quiz {#753
  -id: 38
  -titre: "Un tatouage que j’ai pas aimé .."
  -titreEn: null
  -type: "Cardiologie interventionnelle"
  -typeEn: null
  -auteur: "<p style="text-align:center"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Dr Ben Ali Zine Elabidine, Dr Moussa Karim</span></span></p>"
  -service: "Centre Hospitalier Henry Duffaut -Avignon"
  -serviceEn: null
  -photoAuteur: "IMG_4333.JPG"
  -filephoto: null
  -photoPartager: null
  -commentaire: """
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Les perforations coronaires surviennent dans 0,2 &ndash; 0,8 %&nbsp; des interventions coronariennes percutan&eacute;es. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Elles se produisent le plus fr&eacute;quemment lors du traitement des l&eacute;sions complexes (occlusion chroniques, l&eacute;sions calcifi&eacute;es, tortuosit&eacute;s importantes, anastomose de pontage ) ainsi que lors de l&#39;utilisation des techniques d&#39;ath&eacute;rectomie , des&nbsp; guides hydrophiles ou rigides ou suite&nbsp; &agrave; un surdimensionnement du ballon ou du stent [1]. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Elles se caract&eacute;risent &agrave; l&#39;angiographie par un tatouage ou une extravasation du produit de contraste au niveau d&#39;une art&egrave;re coronaire, et sont g&eacute;n&eacute;ralement reconnues imm&eacute;diatement. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">La cons&eacute;quence la plus grave des perforations coronaires est la tamponnade qui peut &ecirc;tre tardive et peut mener au d&eacute;c&egrave;s[2].</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">La prise en charge th&eacute;rapeutique d&eacute;pend du type de perforation ( Classification de Ellis[3]) et du retentissement h&eacute;modynamique.</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Dans notre cas , il s&rsquo;agit d&rsquo;une perforation coronaire Type III distale&nbsp; par le guide d&rsquo;angioplastie (Whisper extrasupport&nbsp;: guide hydrophile).</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Plusieurs modalit&eacute;s th&eacute;rapeutiques ont &eacute;t&eacute; valid&eacute;es pour traiter ce type de perforation [1-4]&nbsp;: inflation prolong&eacute;e au ballon &agrave; basse pression (5 &agrave; 10 minutes) et/ou&nbsp; embolisation par un Coil&nbsp;; un MicroplugVasculaire&nbsp;; le&nbsp; Polyvinyl Alcool&nbsp;;ou par la graisse sous cutan&eacute;e.&nbsp; Cependant, l&rsquo;int&eacute;r&ecirc;t d&rsquo;une neutralisation de la coagulation par protamine reste encore un sujet de d&eacute;bat . </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Pour notre patient , on a opt&eacute; pour une embolisation&nbsp; par Coil:&nbsp; un cath&eacute;t&eacute;risme s&eacute;lectif de l&rsquo;IVA distale a &eacute;t&eacute; fait par un Microcath&eacute;ter&nbsp; Finecross (Terumo) via un&nbsp; guide conventionnel BMW ainsi deux Coils Vortex (Boston Scientific) ont&nbsp; &eacute;t&eacute; lib&eacute;r&eacute;s en amont de la perforation &agrave; travers le Finecross&nbsp; ce qui a permis de colmater la br&egrave;che . (<strong>s&eacute;quences 2,3,4)</strong></span></span></span></p>\r\n
    \r\n
    <p style="text-align:center"><iframe frameborder="0" src="https://www.youtube.com/embed/BLZ4SYyCAzY" width="80%"></iframe><iframe frameborder="0" src="https://www.youtube.com/embed/P1HHotr3eow" width="80%"></iframe><iframe frameborder="0" src="https://www.youtube.com/embed/q20IcarWlIE" width="80%"></iframe></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">L&rsquo; &eacute;volution ult&eacute;rieur &eacute;tait favorable avec stabilisation de l&rsquo;&eacute;tat h&eacute;modynamique et absence de r&eacute;cidive de l&rsquo;&eacute;panchement p&eacute;ricardique .</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong><span style="background-color:white">R&eacute;f&eacute;rences&nbsp;:</span></strong></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white"><strong>1&nbsp;/Coronary&nbsp;perforation&nbsp;in the&nbsp;drug-eluting&nbsp;stent&nbsp;era:&nbsp;incidence,&nbsp;risk&nbsp;factors,&nbsp;management&nbsp;and&nbsp;outcome: the&nbsp;UK&nbsp;experience. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Hendry%20C%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Hendry C</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fraser%20D%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Fraser D</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eichhofer%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Eichhofer J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Mamas%20MA%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Mamas MA</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fath-Ordoubadi%20F%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Fath-Ordoubadi F</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=El-Omar%20M%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">El-Omar M</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Williams%20P%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Williams P</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Coronary+perforation+in+the+drug-eluting+stent+era%3A+incidence%2C+risk+factors%2C+management+and+outcome%3A+the+UK+experience">EuroIntervention.</a>&nbsp;2012 May 15;8(1):79-86. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong>2/Coronary&nbsp;Artery&nbsp;Perforation&nbsp;and&nbsp;Tamponade&nbsp;Incidence,&nbsp;Risk&nbsp;Factors,&nbsp;Predictors&nbsp;and&nbsp;Outcomes&nbsp;From&nbsp;12&nbsp;Years&#39;&nbsp;Data&nbsp;of the&nbsp;SCAAR&nbsp;Registry. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Harnek%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">Harnek J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=James%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">James S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Lagerqvist%20B%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">Lagerqvist B</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Coronary+Artery+Perforation+and+Tamponade%E3%80%80-+Incidence%2C+Risk+Factors%2C+Predictors+and+Outcomes+From+12+Years%27+Data+of+the+SCAAR+Registry">Circ J.</a>&nbsp;2019 Dec 25;84(1):43-53. </span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong>3/ Increased&nbsp;coronary&nbsp;perforation&nbsp;in the&nbsp;new&nbsp;device&nbsp;era.&nbsp;Incidence,&nbsp;classification,&nbsp;management, and&nbsp;outcome. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Ellis%20SG%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Ellis SG</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Ajluni%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Ajluni S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Arnold%20AZ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Arnold AZ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Popma%20JJ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Popma JJ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Bittl%20JA%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Bittl JA</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eigler%20NL%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Eigler NL</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Cowley%20MJ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Cowley MJ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Raymond%20RE%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Raymond RE</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Safian%20RD%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Safian RD</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Whitlow%20PL%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Whitlow PL</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Increased+coronary+perforation+in+the+new+device+era.+Incidence%2C+classification%2C+management%2C+and+outcome">Circulation.</a>&nbsp;1994 Dec;90(6):2725-30.</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">4&nbsp;. <strong>Management of two major complications in the cardiac catheterisation laboratory: the no-reflowphenomenon and coronary perforations. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Muller%20O%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Muller O</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Windecker%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Windecker S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Cuisset%20T%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Cuisset T</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fajadet%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Fajadet J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Mason%20M%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Mason M</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Zuffi%20A%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Zuffi A</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Doganov%20A%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Doganov A</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eeckhout%20E%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Eeckhout E</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=EuroIntervention.+2008+Aug%3B4(2)%3A181-3.">EuroIntervention.</a>&nbsp;2008&nbsp;Aug;4(2):181-3.</span></span></span></p>\r\n
    """
  -commentaireEn: null
  -description: """
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">Patient &acirc;g&eacute; de 80 ans aux ant&eacute;c&eacute;dents&nbsp;: HTA , DNID , RAO serr&eacute; trait&eacute; par&nbsp; un TAVI en janvier&nbsp; 2017 admis pour une angioplastie programm&eacute;e de l&rsquo;IVA moyenne ( Angor d&rsquo;effort invalidant avec Echo de stress + en ant&eacute;roseptoapical)</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">4 h apr&egrave;s l&rsquo;angioplastie , alt&eacute;ration de l&rsquo;&eacute;tat h&eacute;modynamique du patient avec TAS = 80 mmhg sans douleur thoracique avec &agrave; l&rsquo; ECG&nbsp;: tachycardie sinusale , QRS fins , pas de&nbsp; modifications de la repolarisation</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">ETT: &Eacute;panchement&nbsp; p&eacute;ricardique circonf&eacute;rentiel de grande abondance avec collapsus du VD </span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">Ainsi&nbsp;; le patient a eu un drainage p&eacute;ricardique en urgence (600cc de liquide h&eacute;matique ) et&nbsp; une Coronarographie qui montre un tatouage en regard de l&rsquo;IVA apicale <span style="color:red">( s&eacute;quence 1)</span></span></span></p>
    """
  -descriptionEn: null
  -casdemois: Casdemois {#544 …}
  #question: PersistentCollection {#711 …}
  #media: PersistentCollection {#776 …}
}
_controller 
"Gestion\CasdemoisBundle\Controller\QuizcasdemoisController::ReponseAction"
_converters 
[
  ParamConverter {#585
    -name: "Quiz"
    -class: "GestionCasdemoisBundle:Quiz"
    -options: []
    -isOptional: false
    -converter: null
  }
]
_firewall_context 
"security.firewall.map.context.main"
_route 
"Reponse"
_route_params 
[
  "id" => "38"
]
id 
"38"
quiz 
Quiz {#753
  -id: 38
  -titre: "Un tatouage que j’ai pas aimé .."
  -titreEn: null
  -type: "Cardiologie interventionnelle"
  -typeEn: null
  -auteur: "<p style="text-align:center"><span style="font-size:11.0pt"><span style="font-family:&quot;Calibri&quot;,&quot;sans-serif&quot;">Dr Ben Ali Zine Elabidine, Dr Moussa Karim</span></span></p>"
  -service: "Centre Hospitalier Henry Duffaut -Avignon"
  -serviceEn: null
  -photoAuteur: "IMG_4333.JPG"
  -filephoto: null
  -photoPartager: null
  -commentaire: """
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Les perforations coronaires surviennent dans 0,2 &ndash; 0,8 %&nbsp; des interventions coronariennes percutan&eacute;es. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Elles se produisent le plus fr&eacute;quemment lors du traitement des l&eacute;sions complexes (occlusion chroniques, l&eacute;sions calcifi&eacute;es, tortuosit&eacute;s importantes, anastomose de pontage ) ainsi que lors de l&#39;utilisation des techniques d&#39;ath&eacute;rectomie , des&nbsp; guides hydrophiles ou rigides ou suite&nbsp; &agrave; un surdimensionnement du ballon ou du stent [1]. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Elles se caract&eacute;risent &agrave; l&#39;angiographie par un tatouage ou une extravasation du produit de contraste au niveau d&#39;une art&egrave;re coronaire, et sont g&eacute;n&eacute;ralement reconnues imm&eacute;diatement. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">La cons&eacute;quence la plus grave des perforations coronaires est la tamponnade qui peut &ecirc;tre tardive et peut mener au d&eacute;c&egrave;s[2].</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">La prise en charge th&eacute;rapeutique d&eacute;pend du type de perforation ( Classification de Ellis[3]) et du retentissement h&eacute;modynamique.</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Dans notre cas , il s&rsquo;agit d&rsquo;une perforation coronaire Type III distale&nbsp; par le guide d&rsquo;angioplastie (Whisper extrasupport&nbsp;: guide hydrophile).</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Plusieurs modalit&eacute;s th&eacute;rapeutiques ont &eacute;t&eacute; valid&eacute;es pour traiter ce type de perforation [1-4]&nbsp;: inflation prolong&eacute;e au ballon &agrave; basse pression (5 &agrave; 10 minutes) et/ou&nbsp; embolisation par un Coil&nbsp;; un MicroplugVasculaire&nbsp;; le&nbsp; Polyvinyl Alcool&nbsp;;ou par la graisse sous cutan&eacute;e.&nbsp; Cependant, l&rsquo;int&eacute;r&ecirc;t d&rsquo;une neutralisation de la coagulation par protamine reste encore un sujet de d&eacute;bat . </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">Pour notre patient , on a opt&eacute; pour une embolisation&nbsp; par Coil:&nbsp; un cath&eacute;t&eacute;risme s&eacute;lectif de l&rsquo;IVA distale a &eacute;t&eacute; fait par un Microcath&eacute;ter&nbsp; Finecross (Terumo) via un&nbsp; guide conventionnel BMW ainsi deux Coils Vortex (Boston Scientific) ont&nbsp; &eacute;t&eacute; lib&eacute;r&eacute;s en amont de la perforation &agrave; travers le Finecross&nbsp; ce qui a permis de colmater la br&egrave;che . (<strong>s&eacute;quences 2,3,4)</strong></span></span></span></p>\r\n
    \r\n
    <p style="text-align:center"><iframe frameborder="0" src="https://www.youtube.com/embed/BLZ4SYyCAzY" width="80%"></iframe><iframe frameborder="0" src="https://www.youtube.com/embed/P1HHotr3eow" width="80%"></iframe><iframe frameborder="0" src="https://www.youtube.com/embed/q20IcarWlIE" width="80%"></iframe></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">L&rsquo; &eacute;volution ult&eacute;rieur &eacute;tait favorable avec stabilisation de l&rsquo;&eacute;tat h&eacute;modynamique et absence de r&eacute;cidive de l&rsquo;&eacute;panchement p&eacute;ricardique .</span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong><span style="background-color:white">R&eacute;f&eacute;rences&nbsp;:</span></strong></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white"><strong>1&nbsp;/Coronary&nbsp;perforation&nbsp;in the&nbsp;drug-eluting&nbsp;stent&nbsp;era:&nbsp;incidence,&nbsp;risk&nbsp;factors,&nbsp;management&nbsp;and&nbsp;outcome: the&nbsp;UK&nbsp;experience. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Hendry%20C%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Hendry C</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fraser%20D%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Fraser D</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eichhofer%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Eichhofer J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Mamas%20MA%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Mamas MA</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fath-Ordoubadi%20F%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Fath-Ordoubadi F</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=El-Omar%20M%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">El-Omar M</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Williams%20P%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=22580251">Williams P</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Coronary+perforation+in+the+drug-eluting+stent+era%3A+incidence%2C+risk+factors%2C+management+and+outcome%3A+the+UK+experience">EuroIntervention.</a>&nbsp;2012 May 15;8(1):79-86. </span></span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong>2/Coronary&nbsp;Artery&nbsp;Perforation&nbsp;and&nbsp;Tamponade&nbsp;Incidence,&nbsp;Risk&nbsp;Factors,&nbsp;Predictors&nbsp;and&nbsp;Outcomes&nbsp;From&nbsp;12&nbsp;Years&#39;&nbsp;Data&nbsp;of the&nbsp;SCAAR&nbsp;Registry. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Harnek%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">Harnek J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=James%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">James S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Lagerqvist%20B%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=31813890">Lagerqvist B</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Coronary+Artery+Perforation+and+Tamponade%E3%80%80-+Incidence%2C+Risk+Factors%2C+Predictors+and+Outcomes+From+12+Years%27+Data+of+the+SCAAR+Registry">Circ J.</a>&nbsp;2019 Dec 25;84(1):43-53. </span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><strong>3/ Increased&nbsp;coronary&nbsp;perforation&nbsp;in the&nbsp;new&nbsp;device&nbsp;era.&nbsp;Incidence,&nbsp;classification,&nbsp;management, and&nbsp;outcome. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Ellis%20SG%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Ellis SG</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Ajluni%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Ajluni S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Arnold%20AZ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Arnold AZ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Popma%20JJ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Popma JJ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Bittl%20JA%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Bittl JA</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eigler%20NL%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Eigler NL</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Cowley%20MJ%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Cowley MJ</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Raymond%20RE%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Raymond RE</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Safian%20RD%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Safian RD</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Whitlow%20PL%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=7994814">Whitlow PL</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Increased+coronary+perforation+in+the+new+device+era.+Incidence%2C+classification%2C+management%2C+and+outcome">Circulation.</a>&nbsp;1994 Dec;90(6):2725-30.</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px"><span style="background-color:white">4&nbsp;. <strong>Management of two major complications in the cardiac catheterisation laboratory: the no-reflowphenomenon and coronary perforations. </strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Muller%20O%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Muller O</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Windecker%20S%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Windecker S</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Cuisset%20T%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Cuisset T</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Fajadet%20J%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Fajadet J</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Mason%20M%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Mason M</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Zuffi%20A%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Zuffi A</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Doganov%20A%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Doganov A</a>,&nbsp;<a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Eeckhout%20E%5BAuthor%5D&amp;cauthor=true&amp;cauthor_uid=19110779">Eeckhout E</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=EuroIntervention.+2008+Aug%3B4(2)%3A181-3.">EuroIntervention.</a>&nbsp;2008&nbsp;Aug;4(2):181-3.</span></span></span></p>\r\n
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  -commentaireEn: null
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    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">Patient &acirc;g&eacute; de 80 ans aux ant&eacute;c&eacute;dents&nbsp;: HTA , DNID , RAO serr&eacute; trait&eacute; par&nbsp; un TAVI en janvier&nbsp; 2017 admis pour une angioplastie programm&eacute;e de l&rsquo;IVA moyenne ( Angor d&rsquo;effort invalidant avec Echo de stress + en ant&eacute;roseptoapical)</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">4 h apr&egrave;s l&rsquo;angioplastie , alt&eacute;ration de l&rsquo;&eacute;tat h&eacute;modynamique du patient avec TAS = 80 mmhg sans douleur thoracique avec &agrave; l&rsquo; ECG&nbsp;: tachycardie sinusale , QRS fins , pas de&nbsp; modifications de la repolarisation</span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">ETT: &Eacute;panchement&nbsp; p&eacute;ricardique circonf&eacute;rentiel de grande abondance avec collapsus du VD </span></span></p>\r\n
    \r\n
    <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:16px">Ainsi&nbsp;; le patient a eu un drainage p&eacute;ricardique en urgence (600cc de liquide h&eacute;matique ) et&nbsp; une Coronarographie qui montre un tatouage en regard de l&rsquo;IVA apicale <span style="color:red">( s&eacute;quence 1)</span></span></span></p>
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  -descriptionEn: null
  -casdemois: Casdemois {#544 …}
  #question: PersistentCollection {#711 …}
  #media: PersistentCollection {#776 …}
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