Objectives. The present study aimed to investigate the short- and long-term clinical outcomes of self-made polyurethane-covered stents (PU-CS) in patients for the management of coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Background. Coronary artery perforation is reckoned as a serious complication in PCI and associated with considerable morbidity and mortality. Covered stents have been used for treating the life-threatening CAP during PCI. But in some catheterization laboratories, no commercial CS is immediately available when there is an urgent need for CS to rescue the coronary rupture site. Methods. We retrospectively identified 24 patients who underwent 31 self-made PU-CS implantations due to CAP in Zhongshan Hospital, Fudan University, from June 2015 to January 2020. Results. The total procedural success rate of CS to seal the perforation was 79.2%. Nine patients (37.5%) developed cardiac tamponade, of which 8 patients (33.3%) underwent pericardiocentesis and 4 patients (16.7%) underwent cardiac surgeries. Except for 4 cardiac death cases (16.7%), none of myocardial infarction (MI), target lesion revascularization (TLR), and stent thrombosis (ST) was reported during hospital stay. Data from 22 patients (91.7%) were available at 610.4 ± 420.9 days of follow-up. Major adverse cardiac events (MACE) occurred in 6 patients (27.3%), including 5 cases of cardiac death and one TLR case. Conclusions. Self-made PU-CS demonstrates high rates of successful delivery and sealing of severe CAP during PCI. Although the in-hospital mortality remains high after PU-CS implantation, the long-term follow-up shows favorable clinical outcomes, indicating the feasibility of PU-CS in treating CAP.

中文翻译：

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自制聚氨酯覆膜支架植入治疗冠状动脉穿孔的临床结果

目标。本研究旨在调查自制聚氨酯覆膜支架 (PU-CS) 在经皮冠状动脉介入治疗 (PCI) 期间治疗冠状动脉穿孔 (CAP) 的短期和长期临床结果。背景。冠状动脉穿孔被认为是 PCI 的严重并发症，并与相当大的发病率和死亡率相关。覆膜支架已被用于在 PCI 期间治疗危及生命的 CAP。但在一些导管插入实验室中，当迫切需要 CS 抢救冠状动脉破裂部位时，没有立即可用的商业 CS。方法. 我们回顾性地确定了 2015 年 6 月至 2020 年 1 月在复旦大学中山医院因 CAP 进行了 31 次自制 PU-CS 植入的 24 例患者。结果。CS封孔的总手术成功率为79.2%。9例（37.5%）患者出现心包填塞，其中8例（33.3%）接受了心包穿刺术，4例（16.7%）接受了心脏手术。除4例心源性死亡病例（16.7%）外，住院期间均未报告心肌梗死（MI）、靶病变血运重建（TLR）和支架内血栓形成（ST）。22 名患者 (91.7%) 的数据在 610.4 ± 420.9 天的随访中可用。6例（27.3%）患者发生主要心脏不良事件（MACE），其中5例心源性死亡和1例TLR病例。结论。自制 PU-CS 在 PCI 期间表现出高成功率和严重 CAP 密封。尽管 PU-CS 植入后院内死亡率仍然很高，但长期随访显示良好的临床结果，表明 PU-CS 治疗 CAP 的可行性。