title: Long-term follow-up of polytetrafluoroethylene-covered stents implanted during percutaneous coronary intervention for management of acute coronary perforation.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine/Cardiology, Christiana Care Health System, Newark, DE 19728, USA.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Copeland
authors.forename: James T
authors.initials: JT
authors.lastname: Hopkins
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
authors.forename: Ehsanur
authors.initials: E
authors.lastname: Rahman
mesh_terms: D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation* / Q000401:mortality; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality; D003331:Coronary Vessels / Q000293:injuries; D003691:Delaware; D018572:Disease-Free Survival; D006335:Heart Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene