Characteristics of Coronary Intra- or Extramedial Hematomas Causing Emergent Return to Catheterization Laboratory After Percutaneous Coronary Intervention
Authors' conclusion
Recognition of hematomas is critical to prevent emergent ischemic events.
Study context
- Population
- Patients with intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for de novo native coronary arteries and coronary hematomas, 2007–202340,934 PCIs screened
- Participants
- 22 vs 80
- Exposure
- Emergent event cohort vs control cohort with IVUS-defined hematomas after PCI
- Emergentn = 22
- Controln = 80reference
- Outcome
- Prognostic predictors of emergent ischemic events in IVUS-defined hematomas
- Follow-up
- Within 1 month
Methodological detailssingle-centre, observational
- Single-centre
- Observational
Main finding
As reported in the abstract
Morphologic features associated with an emergent event
Emergent vs ControlOdds ratio (95% CI)
Extramedialvs intramedial hematoma
4.66(1.27–17.1)
Larger hematoma angle, per 90°
4.11(1.47–11.5)
Hematoma ending in a normal artery without a branch
5.28(1.36–20.5)
Greater hinge motion at the stent edge, per 5°
1.96(1.10–3.50)
Observational data: associations, not effects.
Further findings
Emergent return to catheterization laboratory after PCI · within 1 month
- Patients requiring emergent return
- 194 (0.47%)
- Hematomas among ischemic causes
- 24 of 122 (20%)
- Stent thrombosis among ischemic causes
- 61 of 122 [50%]
- Hematoma the leading ischemic cause within 24 hours
MI in emergent patients
- One-half of the emergent patients experienced MI
Original publication
Characteristics of Coronary Intra- or Extramedial Hematomas Causing Emergent Return to Catheterization Laboratory After Percutaneous Coronary Intervention. JACC Cardiovasc Interv. Published 25 May 2026. doi:10.
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