Key result
Newer covered stents improve deliverability over older devices for treating large vessel coronary perforations.
Why the study?
Coronary artery perforation during PCI is a rare but life-threatening complication with limited treatment options due to challenges with existing covered stents.
Newer, more deliverable covered stents like BeGraft and PK Papyrus improve the feasibility of treating life-threatening large vessel coronary perforations compared to older, bulkier options.
May aid perforation management with newer stents; leaves open need for comparative trials.
Coronary artery perforation is an infrequent, but potentially life-threatening complication of percutaneous coronary intervention. There are four types of coronary perforation: (a) large vessel; (b) distal vessel; (c) septal collateral; and (d) epicardial collateral perforation. Implantation of a covered stent is the cornerstone of large vessel perforation treatment and can be used in some distal vessel perforations, when embolization is not feasible. Until now the only available covered stent in the US was the Graftmaster stent (two bare metal stents with a PTFE membrane in-between them), that has high profile and is challenging to deliver and expand. Use of the Graftmaster has been associated with high rates of in-stent restenosis and stent thrombosis. Availability of more deliverable covered stents, such as the BeGraft (Bentley InnoMed GmbH, Hechingen, Germany) and PK Papyrus (BIotronik, Lake Oswego, Oregon, that recently received FDA approval) will greatly facilitate treatment of large vessel coronary perforations.
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Xenogiannis et al. (2019) conducted a review in Coronary artery perforation. Covered stents (Graftmaster, BeGraft, PK Papyrus) was evaluated. The availability of newer, more deliverable covered stents such as BeGraft and PK Papyrus will greatly facilitate the treatment of large vessel coronary perforations compared to older devices.
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