Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation : multicentre CRACK registry

Autor: Jarosław Gorący, Adrian Wlodarczak, Michalina Kołodziejczak, Damian Hudziak, Mateusz Tajstra, Jerzy Bartuś, Wojciech Wojakowski, Wojciech Wańha, Jan Jakub Kulczycki, Mariusz Gąsior, Łukasz Kuźma, Krzysztof Reczuch, Paweł Stachowiak, Dariusz Jagielak, Grzegorz Smolka, Andrzej Ochała, Andrzej Łoś, Mariusz Kowalewski, Miłosz Jaguszewski, Stanisław Bartuś, Katarzyna Sierakowska, Sławomir Dobrzycki, Rafał Januszek, Malwina Smolarek-Nicpoń, Monika Gruz-Kwapisz, Tomasz Roleder, Tomasz Figatowski, Brunon Tomasiewicz
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Cardiovascular Procedures
Myocardial Infarction
Coronary Artery Disease
Kaplan-Meier Estimate
Cardiovascular Medicine
Vascular Medicine
Medical Conditions
Medicine and Health Sciences
Coronary Heart Disease
Myocardial infarction
Registries
Coronary Artery Perforation
education.field_of_study
Multidisciplinary
Angiography
Drug-Eluting Stents
Hematology
Middle Aged
Coronary Vessels
Cardiac surgery
Cardiovascular Diseases
Medicine
Female
Research Article
Acute coronary syndrome
medicine.medical_specialty
Coronary Stenting
Cardiac Surgery
Science
Perforation (oil well)
Population
Cardiology
Surgical and Invasive Medical Procedures
Percutaneous Coronary Intervention
Signs and Symptoms
medicine
Humans
education
Blood Coagulation
Aged
Coagulation Disorders
Unstable angina
business.industry
Angioplasty
Thrombosis
medicine.disease
Surgery
Stent Implantation
Lesions
Clinical Medicine
business
Coronary Angioplasty
Mace
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 5, p e0249698 (2021)
Popis: Background Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation. Methods This multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. The primary endpoint was the composite of major adverse cardiac events (MACEs), defined as cardiac death, target lesion revascularization (TLR), and myocardial infarction (MI). Results The registry included 119 patients (mean age: 68.9 ± 9.7 years, 55.5% men). Acute coronary syndrome, including: unstable angina 21 (17.6%), NSTEMI 26 (21.8%), and STEMI 26 (21.8%), was the presenting diagnosis in 61.3%, and chronic coronary syndromes in 38.7% of patients. The most common lesion type, according to ACC/AHA classification, was type C lesion in 47 (39.5%) of cases. A total of 52 patients (43.7%) had type 3 Ellis classification, 28 patients (23.5%) had type 2 followed by 39 patients (32.8%) with type 1 perforation. Complex PCI was performed in 73 (61.3%) of patients. Periprocedural death occurred in eight patients (6.7%), of which two patients had emergency cardiac surgery. Those patients were excluded from the one-year analysis. Successful sealing of the perforation was achieved in 99 (83.2%) patients. During the follow-up, 26 (26.2%) patients experienced MACE [7 (7.1%) cardiac deaths, 13 (13.1%) TLR, 11 (11.0%) MIs]. Stent thrombosis (ST) occurred in 6 (6.1%) patients [4(4.0%) acute ST, 1(1.0%) subacute ST and 1(1.0%) late ST]. Conclusions The use of covered stents is an effective treatment of CAP. The procedural and 1-year outcomes of CAP treated by CS implantation showed that such patients should remain under follow-up due to relatively high risk of MACE.
Databáze: OpenAIRE
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