A case report of left main perforation treated with BeGraft covered stent

Achim, Alexandru; Krivoshei, Lian; Leibundgut, Gregor

doi:10.1093/ehjcr/ytac230

Cited by 1 publication

(1 citation statement)

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“… 5 A patient in whom the LMT artery perforation was successfully treated using the new covered stent with a good long-term outcome was reported. 9 However, there were few studies reporting the clinical outcome of these stents in patients on a large scale, and therefore, the problem of poor long-term outcomes of covered stents was not well solved. 5 …”

Section: Discussionmentioning

confidence: 99%

The C-CAT sign may predict coronary artery perforation in severe calcified lesions during coronary intervention: a case series

Kawamura

Egami

Nishino

et al. 2023

European Heart Journal - Case Reports

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Background Coronary artery rupture is a rare but fatal complication of percutaneous coronary intervention (PCI). The mortality reaches 19% in patients with the Ellis type Ⅲ classification. The predictors of coronary artery rupture were reported in the previous studies. However, there are few reports showing the risk factors of this threatening complication in terms of intravascular image such as optical coherence tomography and intravascular ultrasound (IVUS). Case Summaries We report the three cases of the coronary artery rupture, who underwent IVUS-guided PCI for severe calcified lesions. All of the three patients developed the Ellis grade Ⅲ rupture, which were successfully managed with perfusion balloon and covered stents. In three cases, the common characteristics were observed at pre-procedural IVUS images. In detail, C-typed CAlcified and residual Thin plaque sign (C-CAT sign) was seen in all of the cases. Discussion These cases provide the insight into the coronary artery rupture in severe calcified lesions. The C-CAT sign at pre-IVUS image may predict the following coronary artery rupture. If we obtain such a unique IVUS image before intervention, we have to consider adapting a smaller balloon size, for example half size down judging from vessel diameter of the reference site or using ablation devices such as orbital atherectomy and rotational atherectomy to prevent coronary artery rupture. Conclusion The C-CAT sign may predict coronary artery perforation in severe calcified lesions during PCI although the larger registries of such intracoronary pre-perforation imaging are warranted in order to correlate different signs with outcomes.

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Section: Discussionmentioning

confidence: 99%