Clinical and procedure characteristics in patients treated with polytetrafluoroethylene-covered stents after coronary perforation: a CIRC-8U multicenter registry and literature review View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-10-09

AUTHORS

Tomonori Itoh, Takumi Kimura, Akihito Kudo, Yoshihiro Morino, Yuji Ikari, Koichiro Yoshioka, Masataka Nakano, Makoto Natsumeda, Masashi Sakuma, Shu Inami, Junya Ako, Makoto Nishinari, Takao Shimohama, Takaaki Komatsu, Tetsuya Ishikawa, Isao Taguchi, Hiroyuki Sugimura, Takanobu Mitarai, Yoshihiro Akashi, Nobuaki Suzuki, Keiki Sugi, Kazuo Matsumoto, Hideyasu Kohshoh, Hideaki Yoshino

ABSTRACT

This study aimed at identifying the clinical characteristics and in-hospital outcomes of patients treated with polytetrafluorethylene (PTFE)-covered stents after coronary interventions in a multicenter registry. Subjects with coronary artery perforation were selected from 31,262 consecutive patients who underwent coronary interventions in the hospital registries. Subjects were divided into two groups: those with a PTFE-covered stent implantation and those without a PTFE-covered stent implantation. Clinical characteristics and in-hospital outcomes were compared between the two groups. Data for 82 consecutive coronary perforations (15 PTFE-covered stents and 67 non-PTFE-covered stents) were extracted from each hospital registry. The PTFE-covered stent group had a higher prevalence of perforations due to pre-dilatation before stenting or post-dilatation after stenting (80% vs. 10.4%; p < 0.001), more Ellis classification III perforations (66.6% vs. 28.4%; p = 0.019), longer perforation to hemostasis time (74 min vs. 10 min; p < 0.001), lower hemostatic success rates (73.3% vs. 94.0%; p = 0.015), and higher in-hospital mortality (26.7% vs. 6.0%; p = 0.015) than the non-PTFE-covered stent group. Although the prevalence of intravascular ultrasound (IVUS) usage was high during coronary interventions (86.7%), IVUS was performed in less than half the cases just before coronary perforations (47%) in the PTFE-covered stent group. Patients requiring PTFE-covered stents are more likely to be observed after balloon dilatation before or after stenting and have a poor prognosis. Careful coronary intervention is needed when IVUS image acquisition is not achieved in addition to proper evaluation of IVUS. Furthermore, if coronary artery perforation occurs, it is important to determine the need for a prompt PTFE-covered stent. More... »

PAGES

418-428

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12928-020-00716-9

DOI

http://dx.doi.org/10.1007/s12928-020-00716-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1131565754

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33037569


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    "description": "This study aimed at identifying the clinical characteristics and in-hospital outcomes of patients treated with polytetrafluorethylene (PTFE)-covered stents after coronary interventions in a multicenter registry. Subjects with coronary artery perforation were selected from 31,262 consecutive patients who underwent coronary interventions in the hospital registries. Subjects were divided into two groups: those with a PTFE-covered stent implantation and those without a PTFE-covered stent implantation. Clinical characteristics and in-hospital outcomes were compared between the two groups. Data for 82 consecutive coronary perforations (15 PTFE-covered stents and 67 non-PTFE-covered stents) were extracted from each hospital registry. The PTFE-covered stent group had a higher prevalence of perforations due to pre-dilatation before stenting or post-dilatation after stenting (80% vs. 10.4%; p\u2009<\u20090.001), more Ellis classification III perforations (66.6% vs. 28.4%; p\u2009=\u20090.019), longer perforation to hemostasis time (74\u00a0min vs. 10\u00a0min; p\u2009<\u20090.001), lower hemostatic success rates (73.3% vs. 94.0%; p\u2009=\u20090.015), and higher in-hospital mortality (26.7% vs. 6.0%; p\u2009=\u20090.015) than the non-PTFE-covered stent group. Although the prevalence of intravascular ultrasound (IVUS) usage was high during coronary interventions (86.7%), IVUS was performed in less than half the cases just before coronary perforations (47%) in the PTFE-covered stent group. Patients requiring PTFE-covered stents are more likely to be observed after balloon dilatation before or after stenting and have a poor prognosis. Careful coronary intervention is needed when IVUS image acquisition is not achieved in addition to proper evaluation of IVUS. Furthermore, if coronary artery perforation occurs, it is important to determine the need for a prompt PTFE-covered stent.", 
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350 grid-institutes:grid.508505.d schema:alternateName Department of Cardiovascular Medicine, Kitasato University Hospital, Sagamihara, Japan
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