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Advances in the treatment of coronary perforations

Iosif Xenogiannis1, Emmanouil S Brilakis1

  • 1Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|April 7, 2019
PubMed

Insights

Coronary artery perforation, a rare but serious complication of percutaneous coronary intervention, can now be better managed. New, more deliverable covered stents offer improved treatment options for large vessel perforations.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Surgery
  • Medical Device Technology

Background:

  • Coronary artery perforation is a rare yet life-threatening complication during percutaneous coronary intervention.
  • Four types of coronary perforation exist: large vessel, distal vessel, septal collateral, and epicardial collateral.

Discussion:

  • The previously available Graftmaster stent in the US had a high profile, making it difficult to deliver and expand.
  • The Graftmaster stent was associated with high rates of in-stent restenosis and stent thrombosis.
  • Newer covered stents like BeGraft and PK Papyrus offer improved deliverability.

Key Insights:

  • The development of more accessible covered stents significantly enhances treatment options for coronary artery perforations.
  • Improved stent technology addresses limitations of previous devices, potentially reducing complications.
  • The PK Papyrus stent recently received FDA approval, expanding clinical choices.

Outlook:

  • Wider availability and use of improved covered stents are expected to facilitate better outcomes for patients with coronary artery perforations.
  • Further research may focus on long-term efficacy and safety of new covered stent technologies.
  • Advancements in covered stent design could lead to reduced procedural complications and improved patient recovery.

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