Understanding large vessel perforation requiring treatment with covered stent implantation: A case series

Large vessel perforation during coronary intervention is a rare but potentially fatal complication, often requiring implantation of a covered stent for resolution. While technology is improving, the long‐term patency of covered stents is less than drug‐eluting stents, and implantation of covered ste...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2024-03, Vol.103 (4), p.570-579
Main Authors: Denby, Kara, Zaczkiewicz, Myron, Banthiya, Sukriti, Mashayekhi, Kambis, Khatri, Jaikirshan
Format: Article
Language:English
Subjects:
Angiography
Angioplasty, Balloon, Coronary - adverse effects
Coronary Angiography - adverse effects
coronary perforation
Coronary Vessels - diagnostic imaging
Coronary Vessels - surgery
covered stenting
Drug-Eluting Stents - adverse effects
Extravasation
Humans
iliac perforation
Implants
Percutaneous Coronary Intervention - adverse effects
Stents - adverse effects
Treatment Outcome
Vascular System Injuries - diagnostic imaging
Vascular System Injuries - etiology
Vascular System Injuries - therapy
vessel perforation
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Summary:Large vessel perforation during coronary intervention is a rare but potentially fatal complication, often requiring implantation of a covered stent for resolution. While technology is improving, the long‐term patency of covered stents is less than drug‐eluting stents, and implantation of covered stents should be used sparingly. Large vessel perforations are complex and often the perforation inflow is not located at the site of extravasation seen on angiography. This can lead to geographic miss when implanting covered stents and necessitate the implantation of additional covered stents which increases the risk for short‐ and long‐term complications. We present a case series to further investigate the anatomy and mechanism of large vessel perforations and guidance on effective covered stent implantation.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30989