PCI on a tear: Not all perforations need coverage

Abstract

Key Points Coronary perforations are a potentially lethal complication of PCI requiring prompt treatment. The study by Rosseel et al demonstrates no difference in 5‐year outcomes in patients with large coronary perforations treated with and without covered stents. Covered stents are effective in treating coronary perforations and are invaluable in the cardiac catheterization lab.

Out of the Mind of Edward B. Diethrich: The Development of the Polytetrafluoroethylene-Covered Coronary Stent

“…5 In Ellis type II and III coronary perforations, covered coronary stents are the treatment of choice, especially after failure of conservative measures such as prolonged balloon inflation. 15,16 Coronary artery aneurysms, localized dilatations with a diameter 1.5 times greater than the adjacent normal segment, occur in 0.2% to 4.9% of patients and usually affect the right coronary artery. Independent of etiology, coronary aneurysms lead to turbulent or sluggish flow, increasing the long-term risk of myocardial infarction.…”

“…5 In Ellis type II and III coronary perforations, covered coronary stents are the treatment of choice, especially after failure of conservative measures such as prolonged balloon inflation. 15,16…”