“Burying” covered coronary stents under drug-eluting stents: A novel approach to ensure long-term stent patency

Covered coronary stent (CS) implantation is associated with a high risk for in-stent restenosis (ISR) and stent thrombosis (ST). We describe the outcomes after overstenting ("burying") CS using contemporary drug-eluting stents (DES). We analyzed short- and long-term outcomes of consecutive...

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Vydané v:	Cardiology journal Ročník 30; číslo 2; s. 196 - 203
Hlavní autori:	Bossard, Matthias, Cioffi, Giacomo Maria, Yildirim, Mustafa, Moccetti, Federico, Wolfrum, Mathias, Attinger, Adrian, Toggweiler, Stefan, Kobza, Richard, Cuculi, Florim
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Poland Wydawnictwo Via Medica 2023 Via Medica
Predmet:	Aged Aged, 80 and over aneurysm Aneurysms Angioplasty Angioplasty, Balloon, Coronary - adverse effects Anticoagulants Cardiology Coronary Angiography - adverse effects Coronary Restenosis - diagnosis Coronary Restenosis - etiology Coronary Restenosis - therapy covered stent Data collection Drug-Eluting Stents - adverse effects Female Heart attacks Humans in-stent restenosis Interventional Cardiology Male Middle Aged percutaneous coronary intervention Percutaneous Coronary Intervention - adverse effects perforation Polymers Risk Factors Stents Stents - adverse effects target lesion failure Thrombosis Thrombosis - etiology Treatment Outcome aneurysm percutaneous coronary intervention in-stent restenosis stents covered stent perforation target lesion failure
ISSN:	1897-5593, 1898-018X, 1898-018X
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Shrnutí:	Covered coronary stent (CS) implantation is associated with a high risk for in-stent restenosis (ISR) and stent thrombosis (ST). We describe the outcomes after overstenting ("burying") CS using contemporary drug-eluting stents (DES). We analyzed short- and long-term outcomes of consecutive patients who had had a CS implanted, which was consecutively covered ("buried") with a third-generation DES. CSs were primarily post-dilated and then covered with a longer DES overlapping the proximal and distal edges of the CS. To ensure optimal stent expansion and appositions, all lesions were post-dilated using adequately sized non-compliant balloons. Between 2015 and 2020, 23 patients (mean age 67 ± 14 years, 74% males) were treated using this novel approach. Reasons for implanting CS included treatment of coronary aneurysms (n = 7; 30%), coronary perforations (n = 13; 57%), and aorto-ostial dissections (n = 3; 13%). All CSs were successfully deployed, and no peri-procedural complications occurred. The median time of follow-up was 24.5 (interquartile range [IQR] 11.7-37.9) months. All patients had a 1-month follow-up (FU) and 19/23 (83%) patients had 12-month FU (FU range 1-60 months). No probable or definite STs occurred, and no cardiovascular deaths were observed. Among patients undergoing angiographic FU (11/23 [48%]), 1/23 showed angiographically significant ISR 6 months post CS implantation. Burying a coronary CS under a DES appears to be a safe and promising strategy to overcome the limitations of the currently available CS devices, including a relatively high risk for target lesion failure due to ISR and ST.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1897-5593 1898-018X 1898-018X
DOI:	10.5603/CJ.a2021.0096