Emergency polytetrafluoroethylene-covered stent implantation to treat right coronary artery perforation during percutaneous coronary intervention

Yorgun, Hikmet; Canpolat, Uğur; Aytemir, Kudret; Oto, Ali̇

doi:10.5603/cj.2012.0118

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Its incidence was reported to be 0.2% -0.6% [1,2].The diagnosis and classification of coronary perforation have been shown in the previous studies [3,4]. In our country, this situation was reported only as case reports in the medical literature, but there was no prospective study about this issue [5]. The interventions performed for type B and C lesions defined in AHA/ACC, and athero ablation procedures that are increasingly practiced have increased the frequency of the occurrence of perforation [6,7].…”

Section: Introductionmentioning

confidence: 38%

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Yıldız¹,

Karakurt²,

Bitigen³

et al. 2013

Health

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Introduction: Although coronary perforation is a rare complication observed during intervenetional procedures, it has a considerably high mortality rate. The prevelance of coronary perforation has been reported to be 0.20% -0.6%. Its sudden development, the patient's agitation and development of rapid collapse render intervention difficult. Materials and Method: The presence of perfusion balloon and covered stent in clinics is life-saving. In the present study, we retrospectively reviewed 17 cases with coronary artery perforation that were treated between 2009 and 2012. Of these patients, 10 (58.8%) were men and 7 (41.2%) were women; the median age was 62.8 ± 8.3 years. The coronary artery perforation resulted from guide wire in 23.5%, balloon dilatation in 58.8% and stent implantation in 17.6%. All the lesions were either type B or C lesions. Results: The extensiveness of perforation was Ellis grade I in 23.5%, grade II in 47.1% and grade III in 29.4% of the cases. In the treatment of the perforation, polytetrafluoroethylene-covered stent graft was implemented in 9 (52.9%) patients, whilst conventional and emergency surgical therapy was performed in 8 (47.1%) patients. Grade I perforations occurred due to the guide wire and were managed with conventional therapy (p < 0.05). Grade II and III perforations resulted from balloon and stent. The majority of these patients were inserted Graft Stent (stent graft in 52.9% and conventional therapy in 23.5% of the cases (p < 0.05). Although all the stent grafts were successfully implanted, the complete control of bleeding was achieved only in 77.7% of the patients. Mortality was not observed in grade I perforation, whilst all cases resulted in mortality had grade III perforation. Conclusion: These data indicate that there is a need for further advanced technology in the coronary artery perforation despite of currently available therapeutic options.

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Section: Introductionmentioning

confidence: 38%

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Yıldız¹,

Karakurt²,

Bitigen³

et al. 2013

Health

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“…The process of study selection is shown in Figure 1. From a total of 319 studies in our search, only 29 reports were included in the analysis 6,8–35 . The description of the included studies is shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Outcomes of patients who undergo percutaneous coronary intervention with covered stents for coronary perforation: A systematic review and pooled analysis of data

Nagaraja

Schwarz

Moss

et al. 2019

Cathet Cardio Intervent

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Objectives: This review aims to evaluate the adverse outcomes for patients after treatment with covered stents. Background: Coronary perforation is a potentially fatal complication of percutaneous coronary revascularization which may be treated using covered stents. Studies have evaluated long-term outcomes among patients who received these devices, but hitherto no literature review has taken place. Methods: We conducted a systematic review of adverse outcomes for patients after treatment with covered stents. Data from studies were pooled and outcomes were compared according to stent type. Results: A total of 29 studies were analyzed with data from 725 patients who received covered stents. The proportion of patients with chronic total occlusions, vein graft percutaneous coronary intervention (PCI), intracoronary imaging and rotational atherectomy were 16.9, 11.5, 9.2, and 6.6%, respectively. The stents used were primarily polytetrafluoroethylene (PTFE) (70%) and Papyrus (20.6%). Mortality, major adverse cardiovascular events, pericardiocentesis/tamponade and emergency surgery were 17.2, 35.3, 27.1, and 5.3%, respectively. Stratified analysis by use of PTFE, Papyrus and pericardial stents, suggested no difference in mortality (p = .323), or target lesion revascularization (p = .484). Stent thrombosis, pericardiocentesis/tamponade and emergency coronary artery bypass surgery (CABG) occurred more frequently in patients with PTFE stent use (p = .011, p = .005, p = .012, respectively). In-stent restenosis was more common with pericardial stent use (<.001, pooled analysis for first-and second-generation pericardial stents). Conclusions: Cases of coronary perforation which require implantation of a covered stent are associated with a high rate of adverse outcomes. The use of PTFE covered stents appears to be associated with more stent thrombosis, pericardiocentesis/ tamponade, and emergency CABG when compared to Papyrus or pericardial stents.

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“…Several devices have been introduced to repair coronary perforations occurring during PCI. Among them, the most popular devices are polytetrafluoroethylene-covered stents made of an inert and biocompatible polymer composed of carbon chains saturated with fluorine (7,9). However, emergency CABG is usually necessary in severe Ellis Type III perforations and cases with hemodynamic compromise even after successful covered stent implantation (1,10).…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac tamponade, myocardial infarction and even death are potential complications (6). Therapeutic options include emergency coronary artery bypass grafting (CABG) surgery, covered stent implantation and embolisation if perforation occurs at distal segments of the coronary artery (7). Previously, Ellis et al (4) described a classification for coronary perforations.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Coronary Artery Perforation with Hand-Made Covered Stent

Şarlı¹,

Baktır²,

Sağlam³

et al. 2013

Erciyes Med J

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Emergency polytetrafluoroethylene-covered stent implantation to treat right coronary artery perforation during percutaneous coronary intervention

Abstract: (Cardiol J 2012; 19, 6: 639-642)

Cited by 6 publications

References 15 publications

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Fatal complication, rescue therapy; covered stent for coronary artery perforation

Outcomes of patients who undergo percutaneous coronary intervention with covered stents for coronary perforation: A systematic review and pooled analysis of data

Successful Treatment of Coronary Artery Perforation with Hand-Made Covered Stent

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