Repair of a coronary pseudoaneurysm with percutaneous placement of a saphenous vein allograft attached to a biliary stent

Kaplan, Barry M.; Stewart, Richard E.; Sakwa, Marc; O’Neill, William W.

doi:10.1002/(sici)1097-0304(199602)37:2<208::aid-ccd23>3.0.co;2-e

Cited by 27 publications

(16 citation statements)

References 12 publications

(6 reference statements)

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“…Recently, catastrophic perforations in native vessels and saphenous vein grafts have also been managed successfully with autologous vein cover stents [25][26][27][28][29][30] or using stents with a PFTE coating, 31,32 and this approach was used successfully in 1 patient in the pesent series. While covered stents are useful in sealing a ruptured coronary vessel, they must be used with caution in regions of significant side branching and they do not appear to reduce restenosis.…”

Section: Management Of Coronary Perforationmentioning

confidence: 99%

Early and Late Clinical Outcomes Following Coronary Perforation in Patients Undergoing Percutaneous Coronary Intervention.

Fukutomi

Suzuki

Popma

et al. 2002

Circ J

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hile coronary perforation is an uncommon complication following percutaneous coronary intervention (PCI), [1][2][3][4][5][6][7][8] it is one that may lead to cardiac tamponade, 6-9 emergency coronary artery bypass surgery (CABG), or pseudoaneurysm formation, 10 with the potential for late coronary rupture. New coronary devices that resect (eg, directional or transluminal extraction atherectomy), ablate (eg, rotational atherectomy or excimer laser angioplasty), or score (eg, the cutting balloon) atherosclerotic plaque may increase the risk of coronary perforation, and a number of angiographic risk factors for its occurrence have been described previously. [11][12][13][14] The use of newer higher-weight and hydrophilic coronary guidewires may also increase the risk of coronary perforation, particularly during the treatment of chronic coronary occlusions. Clinical algorithms for the treatment of coronary perforation based on angiographic and clinical criteria have been Circulation Journal Vol.66, April 2002 less well studied. Moreover, descriptions of the long-term sequelae after coronary perforation, and delineation of the potential risk for late pseudoaneurysm formation and coronary rupture, have been lacking.The present study examines the frequency of coronary perforation during PCI, evaluates the management strategies used to treat the perforation, and describes the long-term prognosis in patients who have developed coronary perforation during PCI. To address these issues, we reviewed our experience with coronary perforation in a consecutive series of 7,443 patients undergoing PCI at a single, highvolume clinical center. Methods Patient PopulationBetween January 1992 and December 1996, 7,443 coronary interventional procedures were performed in the Cardiac Catheterization Laboratory at National Toyohashi Higashi Hospital. These procedures included conventional balloon angioplasty (n=4,895; 65.8%), cutting balloon angioplasty (n=1,274; 17.1%), coronary artery stenting (n=810; 10.9%), directional coronary atherectomy (DCA) (n=440; 5.9%), and transluminal extraction catheter atherectomy (n=24, 0.32%). Coronary perforation is a rare but serious complication that occurs during percutaneous coronary intervention (PCI). This study examines the frequency of coronary perforation during PCI, evaluates the management strategies used to treat perforations, and describes the long-term prognosis of patients who have developed coronary perforation during PCI. Coronary perforations were found in 69 (0.93%) of 7,443 consecutive PCI procedures, occurring more often after use of a new device (0.86%) than after use of balloon angioplasty (0.41%) (p<0.05).Coronary perforation was attributable solely to the coronary guidewire in 27 (0.36%) cases. Coronary perforations were divided into 2 types: (1) Those with epicardial staining without a jet of contrast extravasation (type I, n=51), and (2) those with a jet of contrast extravasation (type II, n=18). Patients with type I and type II perforations were managed by observation only (3...

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Section: Management Of Coronary Perforationmentioning

confidence: 99%

Early and Late Clinical Outcomes Following Coronary Perforation in Patients Undergoing Percutaneous Coronary Intervention.

Fukutomi

Suzuki

Popma

et al. 2002

Circ J

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“…Until recently, the only therapeutic alternative was surgical aneurysm ligation and coronary artery bypass grafting (CABG). Two recent reports describe a novel percutaneous technique using an autologous vein graft-coated stent for the closure of such an aneurysm [10,11]. This type of coated stent was developed and described by Stefanadis et al [14] and is currently under investigation to address stenting limitations such as restenosis and thrombosis [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Until now, most of these aneurysms warranted operative intervention, consisting of coronary ligation and distal bypass [5]. Recently, a novel percutaneous transcatheter technique using autologus vein graft-coated stent has been described for the treatment of such coronary artery aneurysms [10,11]. We describe a case of coronary artery aneurysm formation after recanalization of a totally occluded artery with laser wire and stenting and its closure by this novel technique.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous closure of a coronary aneurysm with a vein-coated stent

Gruberg

Roguin

1998

Cathet. Cardiovasc. Diagn.

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Coronary artery aneurysm is a rare but recognized complication following percutaneous intervention. We report the formation of such an aneurysm after recanalization with Excimer laser wire of a chronic totally occluded left anterior descending coronary artery and stent implantation and its subsequent treatment using an autologous vein graft‐coated stent. Cathet. Cardiovasc. Diagn. 43:308–310, 1998. © 1998 Wiley‐Liss, Inc.

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“…Autologous vein graft-coated stent is a novel type of coronary endoprosthesis developed in our institution, consisting of a conventional stent coated by an autologous vein graft. Application of this type of coated stent both by our institution [14][15][16][17][18][19] and other institutions [20][21][22] yielded very encouraging results. However, taking into consideration the superior long-term results of arterial bypass grafts compared with the vein grafts [1], coating of a stent with an arterial graft instead of a vein graft seems very appealing.…”

Section: Introductionmentioning

confidence: 90%

Arterial autologous graft-stent for treatment of coronary artery disease: A new technique

Stefanadis

Tsiamis

Vlachopoulos

et al. 1997

Cathet. Cardiovasc. Diagn.

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Repair of a coronary pseudoaneurysm with percutaneous placement of a saphenous vein allograft attached to a biliary stent

Cited by 27 publications

References 12 publications

Early and Late Clinical Outcomes Following Coronary Perforation in Patients Undergoing Percutaneous Coronary Intervention.

Early and Late Clinical Outcomes Following Coronary Perforation in Patients Undergoing Percutaneous Coronary Intervention.

Percutaneous closure of a coronary aneurysm with a vein-coated stent

Arterial autologous graft-stent for treatment of coronary artery disease: A new technique

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