title: Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.|Interventional Cardiology, "Antonio E Biagio E Cesare Arrigo" Hospital, Alessandria, Italy.
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Roberta
authors.initials: R
authors.lastname: Serdoz
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.|Department of Cardiology, Pamukkale University, Denizli, Turkey.
authors.forename: Ismail Dogu
authors.initials: ID
authors.lastname: Kilic
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Caiazzo
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.affiliation: Department of Cardiology, University of Eastern Piedmont, Novara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.affiliation: Interventional Cardiology, "Antonio E Biagio E Cesare Arrigo" Hospital, Alessandria, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Pistis
authors.affiliation: Department of Cardiology, University of Eastern Piedmont, Novara, Italy.
authors.forename: Paolo Nicola
authors.initials: PN
authors.lastname: Marino
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D000818:Animals; D020099:Coated Materials, Biocompatible; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation; D023903:Coronary Restenosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D064593:Heterografts; D006736:Horses; D006801:Humans; D007049:Iatrogenic Disease; D008131:London; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*
chemical_list: D020099:Coated Materials, Biocompatible
keywords: coronary rupture; covered stent; pericardium covered stent; saphenous vein graft