Unexpected coronary perforation following adjunctive balloon postdilation after overlapping drug-eluting stent implantation rescued by successful stent graft implantation

2009 ◽  
Vol 132 (1) ◽  
pp. e11-e13 ◽  
Author(s):  
Soon Yong Suh ◽  
Seung-Woon Rha ◽  
Zhe Jin ◽  
Yoshiyasu Minami ◽  
Kangyin Chen ◽  
...  
Keyword(s):  
Stent Graft ◽  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Coronary Perforation ◽  
Drug Eluting ◽  
Stent Graft Implantation ◽  
Graft Implantation

scholarly journals Stent-graft and double-guiding catheter technique to rescue iatrogenic coronary perforation

2021 ◽  
Vol 17 (6) ◽  
pp. 1800-1803
Author(s):  
Ewa Ostrowska ◽  
Aleksandra Gąsecka ◽  
Tomasz Mazurek ◽  
Janusz Kochman
Keyword(s):  
Stent Graft ◽  
Coronary Artery Perforation ◽  
Catheter Technique ◽  
Coronary Perforation ◽  
Percutaneous Coronary ◽  
Life Threatening ◽  
Temporary Closure ◽  
Stent Graft Implantation ◽  
Graft Implantation ◽  
Guiding Catheter

IntroductionCoronary artery perforation (CAP) is an infrequent, yet life-threatening complication of percutaneous coronary interventions, posing a major risk of cardiac tamponade and mortality.Material and methodsWe report on effective management of Ellis type III CAP with use of double-guiding catheter technique and stent-graft implantation.ResultsProlonged balloon inflation via the first guiding catheter allows for temporary closure of the bleeding site. At the same time, stent-graft is inserted via the second guiding catheter to seal the perforation. After rapid deflation of the balloon, the stent is immediately advanced and expanded.ConclusionsThe procedure minimises the time between deflation of the balloon and implantation of the stent-graft, allowing for successful bleeding cessation.

scholarly journals TCTAP A-030 Drug Coated Balloon Versus Drug-eluting Stent for In-stent Restenosis After Drug-eluting Stent Implantation: A Meta-analysis

2021 ◽  
Vol 77 (14) ◽  
pp. S19
Author(s):  
Hendy Bhaskara Perdana Putra ◽  
Quri Meihaerani Savitri ◽  
Wally Wahyu Mukhammad ◽  
Atiyatum Billah ◽  
Alan Dharmasaputra ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Meta Analysis ◽  
Drug Eluting Stent ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Drug Coated Balloon ◽  
In Stent Restenosis

Impact of hinge motion on stent edge restenosis after new generation drug-eluting-stent implantation in RCA

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Jimba ◽  
M Ikutomi ◽  
D Nishijyo ◽  
M Yamasaki ◽  
A Shindou ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Biomechanical Properties ◽  
Plaque Burden ◽  
Drug Eluting Stent ◽  
Landing Zone ◽  
Binary Restenosis ◽  
Drug Eluting ◽  
New Generation ◽  
Hinge Angle

Abstract Background Edge restenosis still occurs after stent implantation, even by using new generation drug-eluting stents (DES) considered to have favorable biomechanical properties. Mechanical stress imposed on the stent edge are thought to be aggravated by hinge motion at a point between the stented and unstented segments, inducing chronic local inflammation and neointimal overgrowth. Purpose The aim of this study was to investigate the association between the development of edge restenosis and hinge motion in right coronary artery (RCA) where the excessive vessel movement is commonly observed. Methods Among consecutive 650 lesions in RCA where new generation DESs were implanted between 2009 and 2019, 427 serial lesions with sets of angiographies at baseline and follow-up (6–18 month) were included. In addition to conventional quantitative angiography analysis, hinge angle at stent edges was measured (Fig. 1). All the appropriate data for intravascular imaging were analyzed for both stent edges and reference segments. Results Binary restenosis occurred in 43 lesions, and 39 of them were referred to re-intervention. Fifty five percent of them were related to stent edges (15 at proximal and 9 at distal edges). Classical risk factors including diabetes and hemodialysis were more prevalent in the restenosis group (p<0.05). Hinge angle was statistically larger in edge restenosis group than body restenosis or no restenosis group (17.3° vs 11.6° vs 10.6°, p<0.001, Fig. 2). In per-edge analysis, hinge angle, dissection and residual plaque ratio were the independent predictors for binary restenosis (Table 1) with the optimal cut-off value of hinge angle 11.5°. The coexistence of excessive hinge angle and residual plaque burden had an amplified effect on the angiographic stenotic progression at stent edge (p for interaction <0.001) and the incidents of binary restenosis (16.7% vs 1.7% p<0.01, Figs. 3,4). Conclusion Substantial stress determined by angulation at the stent edge and its interaction with residual plaque can be considered as one of the plausible mechanisms for edge restenosis. For tortuous RCA lesions, it would be important to decide the stent-landing zone for minimizing hinge motion and optimize the future stent design. Funding Acknowledgement Type of funding source: None

scholarly journals TCTAP A-002 Limitation of Angiographic Parameters in Predicting Residual Ischemia After Drug-eluting Stent Implantation

2021 ◽  
Vol 77 (14) ◽  
pp. S1-S2
Author(s):  
Jaewook Chung ◽  
Jinlong Zhang ◽  
Doyeon Hwang ◽  
Seokhun Yang ◽  
Jeehoon Kang ◽  
...  
Keyword(s):  
Stent Implantation ◽  
Drug Eluting Stent ◽  
Drug Eluting
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