Distribution characteristics and the reasons and curative effects of type III coronary artery perforation with the covered stents implantation

AIM The aim of this study was to analyse the distribution characteristics and the reasons and curative effects of patients with type III coronary perforation who planted covered stent during percutaneous coronary intervention. METHODS Retrospective analysis of recorded patients with type III coronary artery perforation with the covered stents implantation. RESULTS Coronary artery perforation with the covered stents implantation 28 cases (male 20, female 8), the average age is 45-85(66±8) years old. The perforation arteries are LAD 20 cases (71%), LCX 2 cases (7%) and RCA 6 cases (21%), respectively; The lesion type of perforation arteries are type A 16 cases (57%), type C 11 cases (39%), type B2 1 case (4%), CTO 6 cases (21%), severe calcification 11 cases (36%) and myocardial bridge 3 cases (11%), respectively; The causes of perforation are post-expansion with stents balloon 15 cases (54%), stents expansion 6 cases ( 21%), post-expansion with post-expansion balloon 3 cases (11%), and guidewire (11%), respectively. The rate of pericardial tamponade is 61%. The success rates of sealing the rupture site by covered stent is 86%。The in-hospital mortality and major adverse cardiac event rate are 11% and 32%, respectively. 7 cases are followed with CAG, and more than 70% of the stenosis in 3 cases. CONCLUSION The lesion type of type III coronary perforation with covered stents is mainly type A and the mainly cause of perforation is post-expansion with stents balloon. The covered stent is an effective way to seal the rupture site with a high success rate but a high restenosis rate.