期刊
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
卷 80, 期 1, 页码 53-57出版社
WILEY
DOI: 10.1002/ccd.23339
关键词
vessel perforation; stents; coated materials; biocompatible; emergency treatment; treatment outcome
Objective: To determine the long-term outcomes for patients receiving polytetrafluoroethylene (PTFE)-covered stents as definitive therapy, in our institution, for the management of acute coronary perforation. Background: Coronary perforation as a complication of percutaneous coronary intervention (PCI) is associated with high morbidity and mortality. Management options included observation only or a combination of several or all of these approaches: reversal of anticoagulation, prolonged balloon inflation, deployment of a standard stent, emergent cardiac surgery, or insertion of a PTFE-covered stent. Methods: With our IRB approval, records of 12,093 consecutive patients who received PCI during a 5-year period from January 2002 to December 2006 were reviewed and 50 patients who had coronary perforation as a complication of PCI were identified. Results: Of the 21 patients who received a PTFE-covered stent to manage coronary perforation, one died secondary to acute thrombosis within the PTFE-covered stent in the first 24 hrs and one required emergent cardiac surgery due to continued contrast extravasation despite PTFE-covered stent deployment. The other 19 patients were followed long term (mean 55 months) and only one survivor had a potentially life-threatening outcome (subacute stent thrombosis) over that time period. Conclusion: Utilization of a PTFE-covered stent may be a reasonable short- and long-term option to manage acute coronary perforation that occurs during PCI. On the basis of this limited experience, successful PTFE-covered stent deployment as the conclusive treatment for coronary perforation is associated with a favorable long-term event-free survival rate. (c) 2011 Wiley Periodicals, Inc.
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