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Contemporary Use of Coils During Percutaneous Coronary Intervention: Insights From the Multicenter COILSEAL Registry
Enrico Cerrato1,2, Giulio Piedimonte1,2, Marco Franzino3
1Interventional Cardiology Unit, Rivoli Infermi Hospital, Rivoli (Turin), Italy.
Insights
Coil implantation during percutaneous coronary interventions (PCI) is a safe and feasible treatment for coronary perforations and aneurysms/fistulas. This study found high technical success rates with acceptable long-term outcomes.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Medical Devices
Background:
- Coil use in percutaneous coronary interventions (PCI) is life-saving but often off-label.
- This study examines outcomes of coil implantation during PCI.
Purpose of the Study:
- To evaluate in-hospital and long-term outcomes of PCI with coil implantation.
- To assess coil use for coronary perforation, aneurysms, or fistulas.
Main Methods:
- Analysis of 143 patients from 17 European centers undergoing PCI with coil implantation.
- Compared outcomes for coronary perforation versus aneurysm/fistula closure.
- Assessed technical success, procedural success, and major cardiovascular events (MACE).
Main Results:
- High technical success rate (95.7%) for coil implantation.
- Procedural success was lower in the coronary perforation group (83.5%) compared to aneurysm/fistula group (96.6%).
- Target lesion failure occurred in 11.4% at 2-year follow-up, with no group differences.
Conclusions:
- Coil implantation during PCI is safe and feasible for coronary perforations and aneurysms/fistulas.
- The procedure demonstrates high technical success and acceptable long-term safety.
Background:
Use of coils during percutaneous coronary interventions (PCI) is often life-saving and useful, although their off-label use according to the instructions for use.
Aims:
Evaluation of in-hospital and long-term outcomes of patients undergoing PCI with coil implantation for treating coronary perforation or closing coronary artery aneurysms/fistulas.
Methods:
Among 245,652 PCIs performed in 17 high-volume European centers, 143 patients (0.06%) undergoing coil implantation during PCI were finally included in the analysis. PCI strategy (coiling performed during coronary perforation vs. closing aneurysm/fistulas) and procedural devices used were collected. The primary outcome was technical success, defined as the successful sealing of coronary perforation or aneurysm/fistulas, and procedural success defined as technical success without in-hospital major cardiovascular events (MACE). Long-term MACE and mortality were also reported.
Results:
The primary outcome occurred in 95.7% of cases, with no significant differences observed between the perforation and aneurysm/fistulas groups (94.5% vs. 100%, p = 0.19). Patients in the perforation group had a significantly lower rate of procedural success (83.5% vs. 96.6%, p = 0.01). Target lesion failure occurred in 11.4% of cases without differences between groups at a median follow-up of 2 years.
Conclusions:
Coils implantation during PCI is safe and feasible among patients treated for coronary perforations or closing aneurysms/fistulas.
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