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

Parikh, Parth; Banerjee, Kinjal; Sammour, Yasser; Ali, Ambreen; Sankaramangalam, Kesavan; Nair, Ravi; Ellis, Stephen G.; Raymond, Russell; Tuzcu, E. Murat; Kapadia, Samir

doi:10.1002/ccd.28448

Cited by 11 publications

(12 citation statements)

References 19 publications

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“…Pre‐intervention OCT imaging played a key role to measure precisely the length of the aneurysmatic segment, to identify proximal and distal landing zones, and for choosing the appropriate stent size in order to obtain complete sealing. Moreover, the presence of a DES behind the covered stents may have played a role in preventing restenosis 15 . Indeed, the technique proved effective and we were able to exclude the CAA with good clinical and CCTA results at 10‐month follow‐up.…”

Section: Discussionmentioning

confidence: 85%

Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

Fabbiocchi

Calligaris

Bartorelli

2020

Cathet Cardio Intervent

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The development and progressive enlargement over time of multiple saccular coronary artery aneurysms (CAA) after implantation of everolimus‐eluting stent and bioresorbable vascular scaffolds (BVS) have been reported. CAA was successfully excluded by two overlapped covered stents expanded inside a long metallic drug‐eluting stent to avoid dislodgment at the overlap point. Optical coherence tomography (OCT) was repeatedly performed to monitor CAA expansion and to guide treatment through precise measurement of aneurysm length and vessel size at the landing zone. At 10‐month follow‐up, coronary computed tomography angiography showed persistent CAA exclusion. To the best of our knowledge, this is the first report of this technique to exclude a long CCA segment.

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Section: Discussionmentioning

confidence: 85%

Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

Fabbiocchi

Calligaris

Bartorelli

2020

Cathet Cardio Intervent

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“…A number of previous reports addressed the prevalence and the risk profile predisposing to CAPs [2,7]. 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].…”

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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“…The “sandwich design” PTFE-covered stents (Graftmaster RX Coronary Stent Graft System, Abbott Cardiovascular, USA), which are composed of one PTFE material wrapped between two stainless steel stents, are involved with limited deliverability and feasibility when encountering complex coronary anatomies [ 15 ]. Moreover, the performance in the long term was poor due to the high incidence of ISR (25%) and ST (from 3% to 16%) [ 16 – 18 ]. The PK Papyrus CS (Biotronik, USA) was a cobalt-chrome stent platform covered with a single-layer of PU material [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…When compared with similar CS studies with similar sample size, there were striking similarities in the incidence of periprocedural events including pericardial effusion, cardiac tamponade, and pericardiocentesis [ 10 , 18 ]. But our population presented higher rates of emergent surgery after CAP and in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

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

Song

Qin

Chang

et al. 2021

Journal of Interventional Cardiology

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Objectives. The present study aimed to investigate the short- and long-term clinical outcomes of self-made polyurethane-covered stents (PU-CS) in patients for the management of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Background. Coronary artery perforation is reckoned as a serious complication in PCI and associated with considerable morbidity and mortality. Covered stents have been used for treating the life-threatening CAP during PCI. But in some catheterization laboratories, no commercial CS is immediately available when there is an urgent need for CS to rescue the coronary rupture site. Methods. We retrospectively identified 24 patients who underwent 31 self-made PU-CS implantations due to CAP in Zhongshan Hospital, Fudan University, from June 2015 to January 2020. Results. The total procedural success rate of CS to seal the perforation was 79.2%. Nine patients (37.5%) developed cardiac tamponade, of which 8 patients (33.3%) underwent pericardiocentesis and 4 patients (16.7%) underwent cardiac surgeries. Except for 4 cardiac death cases (16.7%), none of myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis (ST) was reported during hospital stay. Data from 22 patients (91.7%) were available at 610.4 ± 420.9 days of follow-up. Major adverse cardiac events (MACE) occurred in 6 patients (27.3%), including 5 cases of cardiac death and one TLR case. Conclusions. Self-made PU-CS demonstrates high rates of successful delivery and sealing of severe CAP during PCI. Although the in-hospital mortality remains high after PU-CS implantation, the long-term follow-up shows favorable clinical outcomes, indicating the feasibility of PU-CS in treating CAP.

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

Cited by 11 publications

References 19 publications

Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

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

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

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