Clinical Outcomes of Self-Made Polyurethane-Covered Stent Implantation for the Treatment of Coronary Artery Perforations

Song, Xiaoyue; Qin, Qing; Chang, Shufu; Xu, Ran; Fu, Mingqiang; Lu, Hao; Ge, Liang; Qian, Juying; Ma, Jianying; Ge, Junbo

doi:10.1155/2021/6661763

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…The recuperation duration following the procedure was not extended, and the patient was discharged without any complications on the 2nd day after the surgery. 19 Song et al 19 compared the clinical outcomes of self-made polyurethane-covered stent (PU-CS) implantation to treat CAP and found that the self-assembled PU-CS exhibited impressive efficacy in achieving successful delivery and sealing of critical CAP during PCI.…”

Section: Discussionmentioning

confidence: 99%

Double set up technique as a bailout of diagonal branch coronary perforation: a case report

Syukri,

Yanni,

Syafri

et al. 2024

Med J Indones

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Coronary artery perforation is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). A 55-year-old male with a history of implanted stent on the left main ostium to the proximal left circumflex artery (LCX) and distal right coronary artery, and chronic total occlusion (CTO) on ostium left anterior descending (LAD). PCI was performed using a stiff wire to cross the CTO body in LAD. We performed an injection and confirmed the presence of extravasation. We successfully managed to stop the bleeding by placing the tips of floppy wire that were cut into pieces. A drainage pathway was made through thoracotomy for pericardial effusion. Angiography showed persisting extravasation at the wire insertion site. We then made our own covered stent. We implanted on the osteal LAD until proximal LCX. Repeated angiography showed no contrast extravasated from the perforation site, and the patient was stabilized and discharged.

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Section: Discussionmentioning

confidence: 99%

Double set up technique as a bailout of diagonal branch coronary perforation: a case report

Syukri,

Yanni,

Syafri

et al. 2024

Med J Indones

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“…Coronary calcification, tortuosity, and poor preparation of the vessel before stent deployment are the major reasons leading to stent loss. [24] Stent loss occurred in 1.3% of PCIs in a meta-analysis of 71,665 PCIs. Recent studies report that an incidence of 0.3%.…”

Section: Covered Stents Available [Figure 6a-c]mentioning

confidence: 99%

Complications of PCI and its Management

Mahilmaran

2023

IJCDW

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Contemporary percutaneous coronary intervention (PCI) has few complications and enhanced safety on one hand and on the other hand, available modern tools have enabled interventional cardiologists to venture into more complex patient subsets and fresh challenges in tackling the ensuing newer complications. Individual operators may take several years of experience before being exposed to the complications and hence, it is important to learn from the collective experience on the detection and management of these complications and better equipped to handle them when the need arises. The complications of PCI can be access related or coronary intervention related. The common acute coronary complications include abrupt vessel closure, thrombus, slow flow, dissection, perforation, stent dislodgement, and guidewire fracture and embolization. The chronic complications include late stent thrombosis, in-stent restenosis, and aneurysm formation. The use of imaging, physiology, and plaque modification tools are associated with specific complications which need to be kept in mind while using them. The successful management of complications needs prompt recognition, involving help from others and continued team effort and vigilance.

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“…Aneu GraftDX is a 316L stainless steel stent covered with equine pericardium, which can be successfully employed in CAP. [15] However, covered stents are not universally available in all catheterization laboratories. Some self-made covered stents can also be developed as a bail-out strategy.…”

Section: Large Cap Covered Stentsmentioning

confidence: 99%

Conquer coronary artery perforation with magic hands

ZOU,

LI,

WANG

et al. 2024

Journal of Geriatric Cardiology

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Coronary artery perforation (CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the perforation of large vessels involves the placement of a covered stent, while the perforation of distal and collateral vessels is typically managed using coils, autologous skin, subcutaneous fat, microspheres, gelatin sponge, thrombin or other substances. However, the above techniques have certain limitations and are not applicable in all scenarios. Our team has developed a range of innovative strategies for effectively managing CAP. This article provides an insightful review of the various tips and tricks for the treatment of CAP. Coronary artery perforation (CAP), called "the nightmare of cath labs", refers to the contrast or blood leaking out of the vessel through tears of coronary artery. The occurrence of CAP is related to the lesion characteristics and the complexity of percutaneous coronary intervention (PCI). In uncomplicated lesions, the incidence of CAP ranges from 0.2% to 0.4%. [1] Older age, female, previous PCI, multivessel lesions, calcification, small and tortuous arteries, use of oversized balloons/stents, high inflation pressures and rotational atherectomy are considered as the risk factors. [2] CAP is more frequently encountered in chronic total occlusion (CTO) PCI with a general incidence of 4%-9% [3] and up to 15% in cases involving the retrograde approach [4] . Apart from increasing the cost of PCI, [5] CAP can result in serious complications such as cardiac tamponade, hemodynamic collapse and even death. [2] CLASSIFICATION AND CLINICAL MANI-FESTATIONSAccording to the location, CAP can be categorized into three types: large vessel perforation, distal vessel perforation and septal/epicardial collateral perforation. Large vessel perforations refer to the tearing of main coronary artery or branch with a diameter of ≥ 2 mm. This type of perforation is often a result of using oversized stents or overinflated balloons, especially in cases of tight and severely calcified lesions. Distal vessel per-forations involve the tearing of distal or small coronary artery branch with a diameter < 2 mm, commonly caused by the movement of distal guidewires like polymerjacketed guidewires. [6] The perforation of septal/epicardial collaterals usually occurs when the retrograde approach is used in CTO PCI. [4] According to angiographic imaging, Ellis, et al. [7] classified CAP into four categories: type I: a crater extending outside the lumen only; type II: pericardial or myocardial blush without a ≥ 1 mm exit hole; type III: frank streaming of contrast through a ≥ 1 mm exit hole; and type III cavity-spilling: perforation into an anatomic cavity chamber. It is important to note that some of these perforations, such as those into the left ventricle, right ventricle, or coronary sinus, do not require treatment. GENERAL PRINCIPLESOnce CAP is confirmed, it is crucial to take immediate steps to prevent furt...

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Clinical Outcomes of Self-Made Polyurethane-Covered Stent Implantation for the Treatment of Coronary Artery Perforations

Cited by 10 publications

References 32 publications

Double set up technique as a bailout of diagonal branch coronary perforation: a case report

Double set up technique as a bailout of diagonal branch coronary perforation: a case report

Complications of PCI and its Management

Conquer coronary artery perforation with magic hands

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