Premium
Is a covered stent justifiable in the treatment of coronary artery perforation? An observational analysis of long‐term results of two different covered stent types
Author(s) -
Rosseel Liesbeth,
Scott Benjamin,
Prihadi Edgard,
Azzano Alessia,
Degrauwe Sophie,
Verheye Stefan,
Convens Carl,
Vermeersch Paul
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27892
Subject(s) - medicine , restenosis , mace , surgery , stent , conventional pci , perforation , retrospective cohort study , medical record , myocardial infarction , materials science , punching , metallurgy
Objectives In this retrospective observational study, we investigate outcome of patients treated with or without covered stent (CS) implantation in the management of coronary artery perforation (CAP) during coronary intervention. Background CSs have shown to be effective devices to achieve acute hemostasis in large CAP. However, doubts have been raised regarding their long‐term outcome. Methods Data of 19 061 PCI procedures during a 10‐year period were reviewed. Fifty‐five cases of large CAP were withheld (Ellis type 2, 3 or cavity spilling). All medical and procedural records of these cases were retrospectively reviewed. Results Twenty‐four (43.6%) patients were treated with CS implantation (15 polytetrafluoroethylene and 9 pericardium CSs). Twenty‐six (47.3%) patients were managed without CS implantation, of whom five had unsuccessful delivery of a CS (stent delivery failure 17.2%). Although significantly more Ellis type‐3 perforations were present in the CS group compared to the Non‐CS group (75.0% vs 45.2%; P = 0.03), in‐hospital mortality was not significantly different (8.3% vs 6.4%; [ P = 0.79]). We observed a high rate of CS restenosis (29.2%) but a lower rate of CS thrombosis (4.2%). Despite these observations, 5‐year MACE and all‐cause mortality were not significantly different between CS and Non‐CS group (respectively, 58.8% vs 50.0% ( P = 0.26) and 26.7% vs 13.3% ( P = 0.36)). Conclusion Although deliverability of CSs was not flawless and a high rate of CS restenosis appeared, short‐ and long‐term outcome were comparable between patients treated with or without CS. Therefore, CSs are justifiable in the treatment of CAP.