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Catheter Cardiovasc Interv. 2016 Mar;87(4):712-9. doi: 10.1002/ccd.26131. Epub 2015 Nov 6.

Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience.

Author information

1
NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
2
Interventional Cardiology, "Antonio E Biagio E Cesare Arrigo" Hospital, Alessandria, Italy.
3
Department of Cardiology, Pamukkale University, Denizli, Turkey.
4
Department of Cardiology, University of Eastern Piedmont, Novara, Italy.

Abstract

BACKGROUND:

The use of covered stent grafts during percutaneous coronary intervention (PCI) is a life saving solution to seal acute iatrogenic vessel rupture. However, the presence of an impenetrable mechanical barrier is also appealing during treatment of friable coronary plaques but the synthetic PTFE-membrane that might trigger excessive neointimal proliferation has limited its elective-use. Pericardium tissue may offer an appealing "natural" alternative. Aim of our study is to report the consecutive 5-year single center experience with the use of pericardium-covered stents (PCS) (ITGI-Medical, Israel) in a variety of emergency and elective applications.

METHODS:

Nineteen consecutive patients undergoing implantation of PCS at the Royal Brompton in the last 5-years. Reasons for PCS implantation included treatment of degenerated vein grafts, large coronary aneurysms, and acute iatrogenic vessel rupture.

RESULTS:

Angiographic success, defined as the ability of the device to be deployed in the indexed lesion with no contrast extravasation with residual angiographic stenosis <30% and a final thrombolysis in myocardial infarction (TIMI)-3 flow was achieved in all cases. Procedural success, defined as the achievement of angiographic success without any major adverse cardiovascular event (MACE) was achieved in 94.7% of patients. In-stent restenosis (ISR) was observed in 26.3% and all patients underwent successful target vessel revascularization with DES (mean time to restenosis 9.0 ± 4.0 months). At a mean follow-up of 32.5 ± 23.3 months no acute or late stent thrombosis was observed.

CONCLUSION:

PCSs were effective in the treatment of friable embolization-prone coronary plaques, sealing of acute iatrogenic vessel rupture and exclusion of large aneurysms with no thrombosis but high target lesion revascularization.

KEYWORDS:

coronary rupture; covered stent; pericardium covered stent; saphenous vein graft

PMID:
26541909
DOI:
10.1002/ccd.26131
[Indexed for MEDLINE]

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