Abstract 4148: Long Term Follow up of Polytetrafluoroethylene-Covered Stents Implanted During Percutaneous Coronary Intervention for Management of Acute Coronary Perforation
BACKGROUND: Coronary perforation during percutaneous coronary intervention (PCI) is a rare but potentially lethal complication. A review of the literature reports an incidence of this complication ranging from 0.2% to 0.6%. Coronary perforation may be induced by a guide wire, balloon inflation, atheroablative devices or with standard stent placement. Perforation can be treated with prolonged balloon inflation, deployment of standard stent, emergent cardiac surgery, or by inserting a polytetrafluoroethylene (PTFE)-covered stent.
METHODS: We retrospectively analyzed records of 12,093 consecutive percutaneous coronary interventions performed in our institution from January 1, 2002 through December 31, 2006 and found a total of 50 coronary perforations (incidence 0.41 %). Out of the 50 patients with coronary perforation, attempt to implant a PTFE covered stent was made in 26 patients. Only 21/26 (80%) patients had a PTFE stent successfully deployed. Due to mechanical or anatomical reason, 5/26 patients could not have a PTFE stent implanted at the desired location. Patients who did not receive PTFE stents, 29/50 (58%), were treated with observation (n=9), prolonged balloon inflation (n=7), implantation of a standard stent (n=2) or cardiac surgery (n=11).
CONCLUSION: Patients who receive a PTFE covered stent for coronary artery perforation during PCI, experience a low incidence of acute complications 2/21(9%) and 19/21(91%) survived long term without any acute events.