Open AccessOutcomes after use of covered stents to treat coronary artery perforations. Comparison of old and new‐generation covered stents
Author(s) -
HernándezEnríquez Marco,
Lairez Olivier,
CampeloParada Francisco,
Lhermusier Thibault,
Bouisset Frédéric,
Roncalli Jérôme,
Elbaz Meyer,
Carrié Didier,
Boudou Nicolas
Publication year - 2018
Publication title -
journal of interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.764
H-Index - 51
eISSN - 1540-8183
pISSN - 0896-4327
DOI - 10.1111/joic.12525
Subject(s) - medicine , mace , restenosis , pericardial effusion , myocardial infarction , covered stent , perforation , clinical endpoint , stent , target lesion , cardiology , surgery , artery , percutaneous coronary intervention , randomized controlled trial , punching , materials science , metallurgy
Objectives To compare outcomes in patients receiving polytetrafluoroethylene (PTFE) and polyurethane (PL) covered stents (CS) after coronary artery perforation (CAP). Background The prognosis of CAP has improved with the advent of CSs. Information is scarce about the outcomes of new‐generation CSs. Methods Sixty‐one patients were treated with CSs in a 5‐years period (age = 77 ± 8.75% males). Procedural and clinical data were retrospectively collected. The primary endpoint was procedural success. Secondary endpoints included death and major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, target vessel, and lesion revascularization and need for surgical repair). Results Twenty‐two (36%) received PL‐CSs and 39 (65%) PTFE‐CSs. There were no differences in procedural success (86% vs 69%, P = 0.216). Time to deliver was shorter with PL‐CS despite larger length of stents (8[11] vs 15[16] min, P = 0.001; 20[5] vs 16[3] mm, P < 0.001). This group had lower rate of pericardial effusion and cardiac arrest (41% vs 72%, P = 0.028; 5% vs 26%, P = 0.045). At 1‐year follow‐up, MACE rates were similar (58% vs 56%, P = 1.000) with atrend toward TVR in the PL‐CS arm (21% vs 5%, P = 0.083). No differences were found in mortality (26% vs 41%, P = 0.385). Each group had 1 stent thrombosis and in‐stent restenosis trended higher in the PL‐CS group (12% vs 3%, P = 0.223). Conclusions Time to deliver was shorter with the PL‐CS and resulted in lower rate of pericardial effusion and cardiac arrest. However, there were no significant differences in procedural success and 1‐year follow‐up MACE in patients treated with PL‐CS or PTFE‐CS.