Pericardial covered stent for coronary perforations

Area of Science:

• Interventional Cardiology
• Cardiovascular Surgery
• Medical Device Technology

Background:

• Iatrogenic coronary perforation is a rare but serious complication of percutaneous coronary interventions (PCI).
• Existing polytetrafluoroethylene (PTFE) covered stents have limitations in deliverability due to bulkiness and inflexibility.
• Pericardial covered stents (PCS) offer a more deliverable alternative for treating coronary perforations.

Purpose of the Study:

• To evaluate the initial and long-term outcomes of using pericardial covered stents (PCS) for treating coronary perforations.
• To assess the safety and efficacy of PCS in complex coronary perforation cases.

Main Methods:

• Retrospective review of electronic databases from four tertiary medical centers (2008-2013).
• Analysis of 18,364 PCI procedures, identifying nine cases of coronary perforation treated with PCS.
• Evaluation of procedural success and clinical outcomes.

Main Results:

• All nine coronary perforation cases were successfully treated with pericardial covered stents.
• Follow-up angiography (2-15 months) in six patients revealed in-stent restenosis in two cases, requiring repeat angioplasty.
• One patient experienced stent thrombosis three months post-implantation, leading to NSTEMI.

Conclusions:

• Pericardial covered stents provide a safe and effective treatment for coronary perforations.
• PCS are a valuable therapeutic option when standard treatments like balloon inflation and anticoagulation reversal are insufficient.