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Treatment of coronary artery perforations complicating percutaneous coronary intervention with a

Alexandra J Lansky1, Yi-ming Yang, Yosef Khan

  • 1Cardiovascular Research Foundation, New York, New York, USA. alansky@crf.org

The American Journal of Cardiology
|July 25, 2006
PubMed

Insights

Coronary artery perforation during PCI is serious. A polytetrafluoroethylene-coated stent graft (CSG) effectively sealed perforations in a large multicenter study, avoiding major adverse events.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Research
  • Medical Device Technology

Background:

  • Coronary artery perforation is a rare but severe complication of percutaneous coronary intervention (PCI).
  • Traditional treatments for coronary perforation carry high risks of mortality, myocardial infarction, and emergency surgery.
  • Limited data exists on the efficacy of stent grafts for sealing coronary perforations.

Purpose of the Study:

  • To evaluate the outcomes of using the JOSTENT coronary stent graft (CSG) in patients with coronary artery perforations.
  • To assess the safety and effectiveness of CSG in managing severe coronary perforations complicating PCI.

Main Methods:

  • A retrospective analysis of an international registry involving 41 patients with coronary perforations.
  • Polytetrafluoroethylene-coated JOSTENT coronary stent grafts (CSGs) were used to treat the perforations.
  • Outcomes including perforation sealing, procedural success, and in-hospital complications were analyzed.

Main Results:

  • The study included severe perforations (29.1% Ellis grade 3).
  • 52 CSGs were successfully deployed in 41 patients, sealing 92.9% of perforations completely and 7.1% partially.
  • The overall procedure success rate was 96.4%, with no in-hospital Q-wave myocardial infarctions, emergency bypass surgeries, or deaths.

Conclusions:

  • The polytetrafluoroethylene-coated JOSTENT coronary stent graft (CSG) is a reliable and highly effective option for sealing coronary perforations.
  • CSG implantation significantly reduces the risk of severe complications associated with coronary artery perforation during PCI.
  • This multicenter series supports the use of CSG as a primary treatment for coronary perforations.

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