Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience

• Published in: Catheterization and cardiovascular interventions Vol. 87; no. 4; pp. 712 - 719
• Main Authors: Secco, Gioel Gabrio, Serdoz, Roberta, Kilic, Ismail Dogu, Caiazzo, Gianluca, Mattesini, Alessio, Parisi, Rosario, De Luca, Giuseppe, Pistis, Gianfranco, Marino, Paolo Nicola, Di Mario, Carlo
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2016; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Angioplasty, Balloon, Coronary - mortality; Animals; Coated Materials, Biocompatible; Coronary Aneurysm - diagnostic imaging; Coronary Aneurysm - mortality; Coronary Aneurysm - physiopathology; Coronary Aneurysm - therapy; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - physiopathology; Coronary Artery Disease - therapy; Coronary Circulation; Coronary Restenosis - etiology; coronary rupture; Coronary Thrombosis - etiology; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Coronary Vessels - surgery; covered stent; Female; Heterografts; Horses; Humans; Iatrogenic Disease; London; Male; Middle Aged; Pericardium - transplantation; pericardium covered stent; Prosthesis Design; Retrospective Studies; Risk Factors; Saphenous Vein - diagnostic imaging; Saphenous Vein - physiopathology; Saphenous Vein - transplantation; saphenous vein graft; Stents; Time Factors; Treatment Outcome; Ultrasonography, Interventional; Vascular System Injuries - diagnostic imaging; Vascular System Injuries - mortality; Vascular System Injuries - physiopathology; Vascular System Injuries - therapy; saphenous vein graft; coronary rupture; covered stent; pericardium covered stent
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.26131

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. Conclusion 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. © 2015 Wiley Periodicals, Inc.