Clinical Outcomes Following Covered Stent for the Treatment of Coronary Artery Perforation

Lee, Wei‐Chieh; Hsueh, Shu-Kai; Fang, Chih-Yuan; Wu, Chiung-Jen; Hang, Chi‐Ling; Fang, Hsiu‐Yu

doi:10.1111/joic.12347

Cited by 38 publications

(49 citation statements)

References 13 publications

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“…In the contemporary series of CAP, the need for emergent surgical repair ranges from 13% to 16% and the in‐hospital mortality from 8% to 20% . These numbers are in agreement with prior publications on PTFE‐CS . In our cohort, rates of death and cardiac surgery were similar to those previously described among patients treated with PTFE‐CS.…”

Section: Discussionmentioning

confidence: 59%

See 1 more Smart Citation

Outcomes after use of covered stents to treat coronary artery perforations. Comparison of old and new‐generation covered stents

Hernández-Enrı́quez

Lairez

Campelo‐Parada

et al. 2018

J Interven Cardiology

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Section: Discussionmentioning

confidence: 59%

“…PTFE‐CS were for years the most commonly available CSs in the interventional laboratories. Consequently, most of the results regarding CS performance are reported with this technology . In 2013, a PL‐CS obtained CE mark for treatment of CAP.…”

Section: Introductionmentioning

confidence: 99%

Outcomes after use of covered stents to treat coronary artery perforations. Comparison of old and new‐generation covered stents

Hernández-Enrı́quez

Lairez

Campelo‐Parada

et al. 2018

J Interven Cardiology

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“…When CAP occurs, it is a serious complication, associated with high mortality rates, ranging from 7% to 44% . Subsequent complications, like intra‐myocardial hematoma or cardiac tamponade, which occur in up to 40%, are reported as catastrophic events with even poorer immediate outcome . In line, emergency surgical repair or coronary artery bypass grafting (CABG) is required in one‐ to two‐thirds of patients with CAP, with high associated morbidity and mortality, as in‐hospital mortality for emergency CABG ranges from 8% to 14% …”

Section: Introductionmentioning

confidence: 99%

“…In cases of uncontrollable bleeding after CAP, implantation of covered stents (CS) represents a potentially life‐saving strategy . The introduction of CS leads to a decrease in the percentage of patients requiring emergency surgery, and improved clinical outcomes .…”

Section: Introductionmentioning

confidence: 99%

Outcome after new generation single‐layer polytetrafluoroethylene‐covered stent implantation for the treatment of coronary artery perforation

Kufner

Schacher

Ferenc

et al. 2018

Cathet Cardio Intervent

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Aims Coronary artery perforation (CAP) is a rare but severe complication during percutaneous coronary intervention (PCI). Implantation of covered stents (CS) represents a potentially life‐saving treatment. Concerns exist regarding limited efficacy and high stent thrombosis (ST) rates related to early generation CS. The aim of this study was to evaluate angiographic and clinical outcomes of patients with CAP treated with a new generation single‐layer polytetrafluoroethylene (PTFE)‐CS. Methods Between May 2013 and November 2017, we identified a total of 61 patients who underwent implantation of 71 single layer PTFE‐CS after CAP. We analyzed angiographic results at follow up (including binary angiographic restenosis [BAR] and late‐lumen‐loss [LLL]) and clinical outcomes in hospital and at follow up, including target lesion revascularization (TLR), cardiovascular‐, and all‐cause mortality, myocardial infarction (MI) and stent thrombosis (ST). Results Procedural success was achieved in all but two patients (96.7%). Procedure related MI, occurred in 19 cases (31.1%), in hospital death occurred in five cases (8.2%). At follow‐up, TLR occurred in 11 cases (18.0%), two patients (3.3%) died from non‐cardiovascular cause, there was no case of MI or ST. Conclusions In this retrospective analysis, implantation of a new generation PTFE‐CS, for the treatment of CAP showed high technical success rates. Although, periprocedural MI—and in‐hospital‐death rates remain not inconsiderable, new generation PTFE‐CS showed favorable angiographic and clinical efficacy and high safety profile, especially with regard to thrombotic events.

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“…However, we do not have data on how these three would compare against each other. A study done Lee et al looked at the clinical outcomes of PTFE covered stents in coronary artery perforations which showed that the 30‐day all‐cause mortality was 16.7% and 1 year all‐cause mortality of 26.2% . Another study by Gercken et al looked at the registry for PTFE covered stents where most of the utilization was for complex lesions and ISR and not particularly focused on coronary artery perforations or aneurysms .…”

Section: Discussionmentioning

confidence: 99%

Utilization and outcomes of polytetrafluoroethylene covered stents in patients with coronary artery perforation and coronary artery aneurysm: Single center 15‐year experience

Parikh

Banerjee

Sammour

et al. 2019

Cathet Cardio Intervent

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Objectives Determine the outcomes of polytetrafluoroethylene (PTFE) covered stents for coronary artery perforation (CAP) and coronary artery aneurysm (CAA). Background PTFE covered stents have been used for treatment of potentially life‐threatening CAP and CAA. The short and long‐term outcomes of the PTFE covered stent for CAP and CAA have not been well studied. Methods We performed a retrospective study of PTFE covered stents that were placed in the patients from 2003 to 2017. Short term outcomes included in‐hospital mortality, pericardial effusion, cardiac tamponade, and length of stay. Long‐term outcomes included target lesion revascularization (TLR), in‐stent restenosis (ISR), and long‐term mortality. Results Fifty‐three PTFE covered stents were placed in 32 patients of which there were 24 patients with a CAP with a mean age of 75 ± 8 years. Two patients died in‐hospital, with no additional deaths at 30 days. The rate of ISR was 25%, with estimated rates of TLR of 2.6% (3 years) and 17.8% (5 years). The median survival was 55.6 months, with survival at 10 years estimated to be 30.9%. Eight patients received a PTFE covered stent for CAA with a mean age of 59 ± 15 years with no in‐hospital or 30‐day mortality. Median follow‐up of 49 months showed no evidence of TLR. The all‐cause mortality was 12% at 1 year and 38% at 3 years. Conclusions PTFE covered stents is an effective option in patients with CAP and CAA. The long‐term outcomes may be related to the pathology of the disease rather than the stent itself.

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Clinical Outcomes Following Covered Stent for the Treatment of Coronary Artery Perforation

Abstract: The covered stent could solve emergent condition for patients with coronary artery perforation with high TLR and stent thrombosis rate at long-term follow-up. The patients with cardiac tamponade had worse clinical outcomes in 30-day and 1-year follow-up.

Cited by 38 publications

References 13 publications

Outcomes after use of covered stents to treat coronary artery perforations. Comparison of old and new‐generation covered stents

Outcomes after use of covered stents to treat coronary artery perforations. Comparison of old and new‐generation covered stents

Outcome after new generation single‐layer polytetrafluoroethylene‐covered stent implantation for the treatment of coronary artery perforation

Utilization and outcomes of polytetrafluoroethylene covered stents in patients with coronary artery perforation and coronary artery aneurysm: Single center 15‐year experience

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