Very long-term outcome of coronary covered stents: a report from the SCAAR registry

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomaterials Science

Background:

• Covered stents are utilized for coronary perforations, often associated with high early adverse event rates.
• Long-term outcomes of covered stent use remain largely uncharacterized.

Purpose of the Study:

• To compare the short- and long-term outcomes of patients treated with covered stents versus conventional stents.
• To evaluate the safety and efficacy of covered stents in a large population cohort.

Main Methods:

• Analysis of Swedish national registries from 2005-2017.
• Comparison of outcomes between 265 patients receiving covered stents and 197,948 patients receiving conventional stents.
• Landmark analysis at one month to assess long-term mortality differences.

Main Results:

• Covered stents demonstrated significantly higher rates of in-stent restenosis, target lesion revascularization, re-infarction, and mortality compared to conventional stents (p<0.001).
• Elevated mortality risk with covered stents was primarily observed within the first month post-procedure.
• No stent thrombosis was reported for equine pericardial covered stents, though overall stent thrombosis was higher for covered stents within one year.
• Long-term mortality, after the initial month, showed no significant difference between covered and conventional stents.

Conclusions:

• Patients treated with covered stents face a significantly elevated risk of adverse events, particularly in the short term.
• Long-term mortality risk appears comparable between covered and conventional stents.
• Equine pericardial covered stents may offer a safer alternative regarding stent thrombosis.