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

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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.

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Acknowledgements

The authors are deeply grateful to the following members of the Cardiovascular Research Centre, Iwate Medical University, and Iwate Core Analysis Laboratory: Yumiko Okuyama (Research Nurse), Kayoko Fujiwara (secretary, Iwate Core Analysis Laboratory), and Kitasato University Hospital: Yuko Osakabe (Clinical Research Coordinator).

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Iwate Medical University, 2-1-1 Idai-dori Yahaba-cho, Shiwa-gun, Iwate, 028-3695, Japan

    Tomonori Itoh, Takumi Kimura, Akihito Kudo & Yoshihiro Morino

  2. Division of Community Medicine, Department of Medical Education, Iwate Medical University, Yahaba-cho, Shiwa-gun, Japan

    Tomonori Itoh

  3. Division of Cardiology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan

    Yuji Ikari, Koichiro Yoshioka, Masataka Nakano & Makoto Natsumeda

  4. Division of Cardiology, Dokkyo Medical University, Mibu, Japan

    Masashi Sakuma & Shu Inami

  5. Department of Cardiovascular Medicine, Kitasato University Hospital, Sagamihara, Japan

    Junya Ako, Makoto Nishinari & Takao Shimohama

  6. Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan

    Takaaki Komatsu, Tetsuya Ishikawa & Isao Taguchi

  7. Division of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, Japan

    Hiroyuki Sugimura

  8. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan

    Takanobu Mitarai & Yoshihiro Akashi

  9. Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan

    Nobuaki Suzuki

  10. Division of Cardiology, Saitama Medical University, Moroyama, Japan

    Keiki Sugi & Kazuo Matsumoto

  11. Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan

    Hideyasu Kohshoh & Hideaki Yoshino

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  1. Tomonori Itoh
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  2. Takumi Kimura
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  3. Akihito Kudo
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the CIRC-8U Study Group

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Correspondence to Tomonori Itoh.

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Itoh, T., Kimura, T., Kudo, A. et al. Clinical and procedure characteristics in patients treated with polytetrafluoroethylene-covered stents after coronary perforation: a CIRC-8U multicenter registry and literature review. Cardiovasc Interv and Ther 36, 418–428 (2021). https://doi.org/10.1007/s12928-020-00716-9

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  • DOI: https://doi.org/10.1007/s12928-020-00716-9

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