Very long-term outcome of coronary covered stents: a report from the SCAAR registry.
Abstract: Covered stents are mostly used for coronary perforations with a high risk of early adverse events; however, their long-term outcome is unknown. The aim of this study was to elucidate the short- and long-term outcome of patients treated with covered stents compared to all other stented patients. Results: The Swedish national registries from 2005-2017 disclosed 265 patients who had received 366 covered stents. Their outcomes were compared to all other stented patients (197,948) who had received 320,784 stents. Compared to regular stents, covered stents showed significant differences (p<0.001) in the short and long term in relation to in-stent restenosis (ISR), target lesion revascularisation (TLR), re-infarction (MI), re-PCI and mortality, the rates of which were all higher. The higher mortality was concentrated within the first month, as a landmark analysis at that time point, adjusted for age and procedural indication, demonstrated no future difference in mortality (HR 1.02 [0.78-1.33], p=0.877). Stent thrombosis (ST) within one year was reported to be higher in covered stents than in other stents. However, no ST was reported in equine pericardial covered stents. Conclusions: This observational study including the entire Swedish population shows that patients receiving covered stents have a significantly higher risk of all adverse events. Reassuringly, in the long term, mortality appears to be similar to that in other stented patients.
Publication Date: 2018-10-31 PubMed ID: 30375337DOI: 10.4244/EIJ-D-18-00855Google Scholar: Lookup
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- Journal Article
- Observational Study
Summary
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This research article studied the long-term effects of using covered stents in treating patients with coronary perforations. The study found that covered stents carry a higher risk of short-term adverse events than regular stents, but the long-term mortality rates are similar.
Research Objective
The primary aim of this research was to investigate both the short-term and long-term outcomes of patients who were treated with covered stents. The research compared these results with those from a larger group of patients who received regular stents.
Research Methodology
- The researchers utilized national health registries in Sweden from a period of 2005 to 2017.
- They identified patients who had received covered stents, a total of 265 individuals who had received a combined 366 individual covered stents.
- The outcomes of these patients were then compared to those of a much larger group – 197,948 patients who had received a total of 320,784 regular stents.
Research Findings
- The results of the study showed that covered stents had significantly different outcomes compared to regular stents in the short-term and long-term.
- The differences were particularly pronounced in relation to in-stent restenosis (ISR), target lesion revascularisation (TLR), re-infraction (MI), repeat percutaneous coronary intervention (re-PCI), and mortality rates. All were higher in patients who received covered stents than those with regular stents.
- The researchers noted that the higher mortality rate was concentrated within the first month. However, after adjusting the data for the patient’s age and reason for the procedure, they found no significant difference in future mortality rates between the covered stent and regular stent groups.
- Reports of stent thrombosis within the first year were higher among covered stents compared to other stents. However, no cases of stent thrombosis were reported in those who received equine pericardial covered stents.
Research Conclusions
- The study concluded that patients who receive covered stents are at a higher risk for all adverse events, particularly in the short term, compared to those who receive regular stents.
- In the long term, however, the mortality rate for patients with covered stents was similar to that of patients with other types of stents.
Cite This Article
APA
Harnek J, James SK, Lagerqvist B.
(2018).
Very long-term outcome of coronary covered stents: a report from the SCAAR registry.
EuroIntervention, 14(16), 1660-1667.
https://doi.org/10.4244/EIJ-D-18-00855 Publication
Researcher Affiliations
- Department of Coronary Heart Disease and Institution of Clinical Sciences, Lund University, Lund, Sweden.
MeSH Terms
- Animals
- Coronary Angiography
- Coronary Restenosis
- Horses
- Humans
- Percutaneous Coronary Intervention
- Registries
- Risk Factors
- Stents
- Sweden
- Treatment Outcome
Citations
This article has been cited 3 times.- Mézier A, Dauphin C, Souteyrand G, Motreff P. Unusual interventional treatment of a complex calcified coronary artery lesion in a child with Kawasaki disease: a case report.. Eur Heart J Case Rep 2022 Aug;6(8):ytac332.
- Bartuś J, Januszek R, Hudziak D, Kołodziejczak M, Kuźma Ł, Tajstra M, Figatowski T, Pawłowski T, Gruz-Kwapisz M, Smolarek-Nicpoń M, Skoczyńska A, Tomasiewicz B, Włodarczak A, Kulczycki J, Plens K, Jaguszewski M, Dobrzycki S, Ochała A, Gąsior M, Reczuch K, Bartuś S, Wojakowski W, Wańha W. Clinical Outcomes following Large Vessel Coronary Artery Perforation Treated with Covered Stent Implantation: Comparison between Polytetrafluoroethylene- and Polyurethane-Covered Stents (CRACK-II Registry).. J Clin Med 2021 Nov 21;10(22).
- Wańha W, Januszek R, Kołodziejczak M, Kuźma Ł, Tajstra M, Figatowski T, Smolarek-Nicpoń M, Gruz-Kwapisz M, Tomasiewicz B, Bartuś J, Łoś A, Jagielak D, Roleder T, Włodarczak A, Kulczycki J, Kowalewski M, Hudziak D, Stachowiak P, Gorący J, Sierakowska K, Reczuch K, Jaguszewski M, Dobrzycki S, Smolka G, Bartuś S, Ochała A, Gąsior M, Wojakowski W. Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry.. PLoS One 2021;16(5):e0249698.
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