Long‐term follow‐up of covered stent implantation for various coronary artery diseases

Hachinohe, Daisuke; Latib, Azeem; Laricchia, Alessandra; Iannopollo, Gianmarco; Demir, Ozan M.; Ancona, Marco; Mangieri, Antonio; Regazzoli, Damiano; Giannini, Francesco; Azzalini, Lorenzo; Mitomo, Satoru; Chieffo, Alaide; Montorfano, Matteo; Carlino, Mauro; Colombo, Antonio

doi:10.1002/ccd.28117

Cited by 20 publications

(14 citation statements)

References 30 publications

(53 reference statements)

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“…Even more, the rates of TLR and ST continued to increase, up to 38.7 and 17.8% at 10 years, respectively. 19 In this regard, we describe a 16.2% rate of TLR and 7.7% ST rate during the first year.…”

Section: Discussionmentioning

confidence: 73%

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Use and outcomes of the PK Papyrus covered stent in France: SOS PK Papyrus Registry

Hernández-Enrı́quez

Belle

Madiot

et al. 2020

Cathet Cardio Intervent

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Objectives: To evaluate the rate of procedural success and long-term outcomes of the PK Papyrus (PKP) covered stent (CS).Background: CS are essential in the treatment of coronary artery perforation (CAP).They have also been used to treat coronary artery aneurysms. Limited evidence is available on clinical outcomes with the PKP.Methods: This was a multicenter, observational, retrospective, and prospective study. Consecutive patients undergoing intentional PKP implantation in 22 centers in France were included. The primary endpoint was the rate of procedural success. Secondary endpoints included rates of death, myocardial infarction (MI), target lesion revascularization (TLR), in-stent restenosis (ISR), and stent thrombosis (ST).Results: Data from 130 patients were analyzed (mean age 72.5 ± 10.5 years; 71% men). The main indication for PKP was CAP, in 84 patients (65%). Delivery success was achieved in 95% and procedural success in 91%. During the in-hospital stay, 15 patients died (12%) and 7 (5%) presented with ST. Data from 127 patients were available at 19.2 ± 12.8 month follow-up. Thirty-three patients died (26%), 15 (12%) had an MI and 21 (17%) presented with TLR. TLR was due to ISR in 12 patients (9%), 10 had definite ST (8%) and 1 patient for stent under-expansion. Conclusions:The principal indication for PKP was CAP. PKP had high rates of delivery and procedural success. At long-term follow-up, there was a high rate of TLR, mainly due to ISR and ST. These results are consistent with previously reported data in these clinical settings.

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Section: Discussionmentioning

confidence: 73%

“…18 In our study, CAA was the second most frequent indication for PKP, in accordance with recent reports of CS. 19,20 However, information regarding CS in CAA is heterogeneous and limited to small series of patients, highlighting the unmet need for a largescale registry in this setting.…”

Section: Discussionmentioning

confidence: 99%

Use and outcomes of the PK Papyrus covered stent in France: SOS PK Papyrus Registry

Hernández-Enrı́quez

Belle

Madiot

et al. 2020

Cathet Cardio Intervent

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“…The combination of multiple factors contributes to the increased risk of CAP and the subsequent adverse events such as pericardial effusion or cardiac tamponade: female sex, older age, calcified coronary arteries, complex coronary lesions, previous coronary artery bypass grafting, or rotational atherectomy procedures [7,[16][17][18]. Studies assessing CAP presented significantly higher morbidity and mortality compared to an uncomplicated PCI, with a potential of an improvement of outcomes post-CS implantation [5,8,19]. The implantation of CS is a standard of care in patients with persistent CAP bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…During a one-year follow-up, they found a high number of adverse events with 3.6% of ST and 34.3% of MACE, respectively. In another study, Hachinohe et al [ 19 ] assessed CSs performance in 53 CAPs lesions, with 81% of Graftmaster (Abbot Vascular, Santa Clara, CA) stents used. During a 1-year follow-up, the authors noted 19.6% TLRs, followed by 41.6% at 10-years and 11.9% STs at one year followed by 23.9% at 10-years.…”

Section: Discussionmentioning

confidence: 99%

Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry

et al. 2021

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Background Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation. Methods This multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. The primary endpoint was the composite of major adverse cardiac events (MACEs), defined as cardiac death, target lesion revascularization (TLR), and myocardial infarction (MI). Results The registry included 119 patients (mean age: 68.9 ± 9.7 years, 55.5% men). Acute coronary syndrome, including: unstable angina 21 (17.6%), NSTEMI 26 (21.8%), and STEMI 26 (21.8%), was the presenting diagnosis in 61.3%, and chronic coronary syndromes in 38.7% of patients. The most common lesion type, according to ACC/AHA classification, was type C lesion in 47 (39.5%) of cases. A total of 52 patients (43.7%) had type 3 Ellis classification, 28 patients (23.5%) had type 2 followed by 39 patients (32.8%) with type 1 perforation. Complex PCI was performed in 73 (61.3%) of patients. Periprocedural death occurred in eight patients (6.7%), of which two patients had emergency cardiac surgery. Those patients were excluded from the one-year analysis. Successful sealing of the perforation was achieved in 99 (83.2%) patients. During the follow-up, 26 (26.2%) patients experienced MACE [7 (7.1%) cardiac deaths, 13 (13.1%) TLR, 11 (11.0%) MIs]. Stent thrombosis (ST) occurred in 6 (6.1%) patients [4(4.0%) acute ST, 1(1.0%) subacute ST and 1(1.0%) late ST]. Conclusions The use of covered stents is an effective treatment of CAP. The procedural and 1-year outcomes of CAP treated by CS implantation showed that such patients should remain under follow-up due to relatively high risk of MACE.

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“…RECOVERS studies [25] have found similar results, and the incidence of subacute thrombosis within 30 days of PTFE stent placement was higher than that of traditional stent placement. Hachinohe et al [26] performed a retrospective study of 190 patients implanted with PTFE-covered stents over 20 years and found that target vessel myocardial infarction, occlusion, revascularization and in-stent thrombosis events occurred at the early stage after stent implantation, and their incidence increased gradually in the long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic Analysis of Single And Double Bare-metal Stents For Coronary Artery Aneurysm

Yang¹,

Yuan²,

Cui³

et al. 2021

Preprint

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Background The aim of this study was to investigate a novel method to treat coronary artery aneurysms(CAAs).Methods Three CAAs patients who underwent single or double bare-metal stent implantation were recruited. The CAAs and parent artery diameters were measured for model construction. Single- and double-stent implantation were simulated, and the changes in the CAAs haemodynamics after stenting were analysed. Results In Case 1, the flow velocity in the single-stent model was significantly lower than that in the double-stent model (0.0046±0.013 vs 0.0050±0.011, p<0.001), while the pressure (127.33±18.03 vs 121.19±26.92, p<0.001) and wall shear stress (WSS, 0.28±1.19 vs 0.22±1.13, p<0.001) were significantly higher. In Case 2, the flow velocity (0.005±0.011 vs 0.007±0.01, p<0.001) and WSS (0.17±0.82 vs 0.23±0.88, p<0.001) in the double-stent model were significantly lower than those in the single-stent model, while the pressure was significantly higher(117.70±10.07 vs 110.64±6.34, p<0.001). The same tendency was also observed in Case 3. All CAAs occluded during the follow-up period without obvious in-stent restenosis.Conclusion Application of the single or double bare-metal stent technique, according to the neck diameter of the coronary artery aneurysms, can effectively change the flow in vessels and aneurysm haemodynamics to achieve occlusion.Trail registration: Clinicaltrails, NCT04265989. Registered 12 February 2020, https://clinicaltrials.gov/ct2/show/NCT04265989?term=NCT04265989&draw=2&rank=1

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Long‐term follow‐up of covered stent implantation for various coronary artery diseases

Cited by 20 publications

References 30 publications

Use and outcomes of the PK Papyrus covered stent in France: SOS PK Papyrus Registry

Use and outcomes of the PK Papyrus covered stent in France: SOS PK Papyrus Registry

Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry

Haemodynamic Analysis of Single And Double Bare-metal Stents For Coronary Artery Aneurysm

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