Emergency Covered Stent Implantation For Rupture Of A Pulmonary Vein After Balloon Angioplasty For Postinterventional Pulmonary Vein Stenosis

Hilbert, Sebastian; John, Silke; Riede, Frank-Thomas; Arya, Arash; Paetsch, Ingo; Jahnke, Cosima; Hindricks, Gerhard; Bollmann, Andreas

doi:10.4022/jafib.1418

Cited by 2 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The most feared complication, pulmonary vein tear, can likely be diminished by gradual dilation of larger vessels with a smaller balloon prior to placement of a large stent, as we are currently doing. Covered stents have been used in some patients and can certainly be used to treat a tear emergently, but long‐term follow‐up of these stents in pulmonary veins is still very limited . Strict adherence to anticoagulation maintaining the activated clotting time at 250–300, careful de‐airing, and frequent flushing of long sheaths during these sometimes long procedures should keep the risk of stroke at very low levels.…”

Section: Discussionmentioning

confidence: 99%

Long‐term outcome of percutaneous intervention for pulmonary vein stenosis after pulmonary vein isolation procedure

Suntharos

Worley

Liu

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives Report long‐term outcomes of percutaneous intervention in patients with pulmonary vein stenosis (PVS) after pulmonary vein isolation (PVI) from a single center over 16 years. Background Outcome reports of percutaneous intervention for PVS resulting from PVI are limited. Methods Retrospective review of all patients with PVS after PVI who underwent percutaneous intervention at the Cleveland Clinic Foundation between January 2000 and December 2016. Results A total of 205 patients underwent cardiac catheterization for PVS during the study period. Completely occluded veins which could not be recanalized occurred in six patients. Of the remaining 199 patients, 27 (14%) were lost to follow‐up, leaving 172 patients with 276 veins for analysis. Balloon angioplasty was performed in 62 veins and stent implantation in 250 (primary in 214, to treat postdilation restenosis in 36). Re‐intervention occurred in 45/62 (73%) balloon‐dilated veins and 45/250 (18%) stented veins. Freedom from re‐intervention at 1 and 5 years was 90 and 73% following stenting versus 40 and 23% following balloon dilation (p < .001, Hazard ratio (HR) = 5.7). Veins with stent diameter ≥7 mm (n = 231) had greater freedom from re‐intervention (95% at 1 year, 79% at 5 years) than veins with stents <7 mm (43% at 1 year, 9% at 5 years), p < .001. There was clear symptomatic improvement after intervention and no procedural mortality. Conclusions Stent implantation at ≥7 mm for PVS after PVI is associated with low rates of re‐intervention, in contrast to balloon dilation and stenting with small conventional stents.

show abstract

Section: Discussionmentioning

confidence: 99%

Long‐term outcome of percutaneous intervention for pulmonary vein stenosis after pulmonary vein isolation procedure

Suntharos

Worley

Liu

et al. 2019

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…With this case, we want to show a possible (and dangerous) complication of PMBV, if the catheter placement is incorrect and unrecognized before balloon inflation. Apparently, only a few cases of PV rupture, either iatrogenic [2] or due to blunt chest trauma [3,4], have been reported. To our best knowledge, no reports of PV injury during PMBV have been presented before.…”

mentioning

confidence: 99%