Utilization and outcomes of polytetrafluoroethylene covered stents in patients with coronary artery perforation and coronary artery aneurysm: Single center 15-year experience

Catheter Cardiovasc Interv. 2019 Oct 1;94(4):555-561. doi: 10.1002/ccd.28448. Epub 2019 Aug 20.

Abstract

Objectives: Determine the outcomes of polytetrafluoroethylene (PTFE) covered stents for coronary artery perforation (CAP) and coronary artery aneurysm (CAA).

Background: PTFE covered stents have been used for treatment of potentially life-threatening CAP and CAA. The short and long-term outcomes of the PTFE covered stent for CAP and CAA have not been well studied.

Methods: We performed a retrospective study of PTFE covered stents that were placed in the patients from 2003 to 2017. Short term outcomes included in-hospital mortality, pericardial effusion, cardiac tamponade, and length of stay. Long-term outcomes included target lesion revascularization (TLR), in-stent restenosis (ISR), and long-term mortality.

Results: Fifty-three PTFE covered stents were placed in 32 patients of which there were 24 patients with a CAP with a mean age of 75 ± 8 years. Two patients died in-hospital, with no additional deaths at 30 days. The rate of ISR was 25%, with estimated rates of TLR of 2.6% (3 years) and 17.8% (5 years). The median survival was 55.6 months, with survival at 10 years estimated to be 30.9%. Eight patients received a PTFE covered stent for CAA with a mean age of 59 ± 15 years with no in-hospital or 30-day mortality. Median follow-up of 49 months showed no evidence of TLR. The all-cause mortality was 12% at 1 year and 38% at 3 years.

Conclusions: PTFE covered stents is an effective option in patients with CAP and CAA. The long-term outcomes may be related to the pathology of the disease rather than the stent itself.

Keywords: coronary artery aneurysm; coronary artery perforation; covered stents; outcomes.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / mortality
  • Coronary Aneurysm / physiopathology
  • Coronary Aneurysm / therapy*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / injuries*
  • Coronary Vessels / physiopathology
  • Female
  • Heart Injuries / diagnostic imaging
  • Heart Injuries / mortality
  • Heart Injuries / physiopathology
  • Heart Injuries / therapy*
  • Hospital Mortality
  • Humans
  • Male
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Percutaneous Coronary Intervention / mortality
  • Polytetrafluoroethylene*
  • Prosthesis Design
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome

Substances

  • Polytetrafluoroethylene