Long-term follow-up of polytetrafluoroethylene-covered stents implanted during percutaneous coronary intervention for management of acute coronary perforation

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. © 2011 Wiley Periodicals, Inc.