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

• 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
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.30989

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.