Repair of coronary artery perforation following angioplasty using TachoSil® patches

Celiento, Michele; Scioti, Giovanni; Pratali, Stefano; Bortolotti, Uberto

doi:10.1510/icvts.2009.225334

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…A lower pretreatment bleeding rate in animals receiving clopidogrel and ASA was observed; however, this is likely due to normal variation in bleeding and minor systematic imprecision in the collection of spurting blood. FTC was selected as a comparator, as it has been investigated for use in sutureless coronary artery [19] and ventricular wall repair [20] and in a similar porcine aortotomy model [11].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

Baumgartner

Draxler

Lewis

2016

Journal of Investigative Surgery

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Purpose: The perioperative management of patients on antithrombotic therapy is currently an unresolved problem as these therapies pose a considerable risk for perioperative hemorrhagic complications. The presented studies investigated the efficacy of a new collagen technology to achieve hemostasis. A polyethylene glycol-coated collagen pad (PCC) was compared to a marketed fibrinogen-thrombin coated collagen pad (FTC) for the treatment of an aortotomy incision in heparinized swine on dual antiplatelet therapy. Materials and Methods: Twenty-eight 3-mm aortotomy incisions were created in nine heparinized pigs without antiplatelet therapy and treated with PCC. Sixty-eight aortotomy incisions were created in ten heparinized pigs that received clopidogrel (10-11 mg/kg) and acetylsalicylic acid (8-11 mg/kg) orally for 5 days, and treated with either PCC or FTC (N = 34/group). Dual antiplatelet therapy resulted in significantly reduced platelet function. Aortotomy incisions resulted in lifethreatening bleeding of 35-292 ml/min. Results: In animals without antiplatelet treatment, PCC provided 96% immediate hemostatic success. In animals with antiplatelet treatment, FTC provided 18% immediate hemostatic success increasing to 74% after 10 min. Strikingly, PCC provided 94% immediate success increasing to 100% after 10 min. Controlling for differences in pretreatment bleeding rates, statistical model-estimated time to hemostasis was 12 times shorter in PCC-treated lesions (p < .02). Conclusion: The combination of a procoagulant collagen pad with a synthetic sealing component provides excellent hemostatic properties under a worst-case scenario. PCC rapidly and firmly adheres to tissue, thereby controlling severe arterial bleeding, even when platelet function is significantly reduced. Treatment with PCC provided superior time to hemostasis compared to FTC.

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Section: Discussionmentioning

confidence: 99%

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

Baumgartner

Draxler

Lewis

2016

Journal of Investigative Surgery

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“…TachoSil ® has been used safely and successfully in patients undergoing lung, kidney or liver resection, and, more recent-ly, also in cardiovascular operations [5]. In isolated reports, it has also been applied to control high-pressure bleeding related to coronary perforation during percutaneous interventions [6]. However, no report exists regarding its use for FWR repair.…”

Section: Discussionmentioning

confidence: 99%

“…Despite improved results with wide epicardial patching and sutureless techniques compared with conventional infarctectomy [2][3][4], FWR still remains a surgical challenge. TachoSil ® (Nycomed, Zurich, Switzerland), an equine collagen patch coated with human fibrinogen and human thrombin, has also recently been used as a haemostatic agent in cardiovascular operations, including coronary perforation during percutaneous interventions [5,6], but its use for FWR has not been previously reported. We describe our initial experience, using TachoSil ® for FWR repair.…”

Section: Introductionmentioning

confidence: 99%

TachoSil(R) for postinfarction ventricular free wall rupture

Pocar

Passolunghi

Bregasi

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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Despite a decline in the last three decades, postinfarction ventricular free wall rupture still complicates more than 3% of acute ST-elevation myocardial infarctions and remains a surgical challenge. TachoSil (Nycomed, Zurich, Switzerland) is an equine collagen patch coated with human fibrinogen and human thrombin, which has recently been used for haemostasis in cardiovascular surgery, but its potential usefulness in free wall rupture has not been reported. Initial clinical experience with an on-pump sutureless technique without cardioplegia, using wide TachoSil patching to achieve free wall rupture repair, has been described.

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“…A therapeutic option may include surgical suturing or ligation of the artery with subsequent coronary artery bypass grafting [8]. However, it is easier to refer for surgery a patient with 3-vessel disease than a patient with 1-vessel disease (the patient had a history of a successful PCI of the CX with DES implantation) when the risk of cardiac surgery may outweigh the benefits.…”

Section: Prawa Tętnica Wieńcowa (Projekcja Lao 17° Cra 19°) -Masywmentioning

confidence: 99%

“Cavity spilling” perforation during recanalisation of the right coronary artery – reocclusion of the recanalised artery as a method of emergency treatment

Kurianowicz¹,

Zapolski²,

Wróbel³

et al. 2012

pwki

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A b s t r a c tCoronary artery perforation is an uncommon but potentially life-threatening complication of percutaneous coronary interventions. We report a case of a 78-year-old patient with "cavity spilling" right coronary artery perforation leading to formation of a fistula with contrast spilling directly to the right ventricle which occurred during recanalisation of the chronically occluded coronary artery. This rare complication was treated with a polytetrafluoroethylene-covered stent graft implanted into the right ventricular artery at the site of the right ventricular branch, followed by reocclusion of the right coronary artery and complete patient recovery. A control coronary angiography after 6 months has been scheduled.Key words: perforation, coronary artery fistula, cavity spilling, stent graft S t r e s z c z e n i e Perforacja tętnicy wieńcowej jest rzadkim powikłaniem przezskórnych interwencji wieńcowych, stanowiącym potencjalne zagrożenie życia. Przedstawiono przypadek perforacji typu cavity spilling prawej tętnicy wieńcowej w czasie rekanalizacji długotrwale zamkniętej tętnicy u 78-letniej chorej z wytworzeniem przetoki do prawej komory serca. To niezwykle rzadkie powikłanie opanowano poprzez implantację do początkowego odcinka prawej tętnicy wieńcowej i jej gałęzi prawokomorowej stentgraftu pokrytego politetrafluoroetylenem, co spowodowało ponowne zamknięcie rekanalizowanej tętnicy, ale pozwoliło na pełną stabilizację stanu chorej. Zaplanowano wykonanie kontrolnej koronarografii za 6 miesięcy.

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Repair of coronary artery perforation following angioplasty using TachoSil® patches

Cited by 8 publications

References 8 publications

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

Treatment of Severe Aortic Bleeding Using Hemopatch in Swine on Dual Antiplatelet Therapy

TachoSil(R) for postinfarction ventricular free wall rupture

“Cavity spilling” perforation during recanalisation of the right coronary artery – reocclusion of the recanalised artery as a method of emergency treatment

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