Study Reports Long‐Term Follow‐Up of Covered Stent Implantation for Various Coronary Artery Diseases
February 19, 2019—In Catheterization and Cardiovascular Interventions (CCI), Daisuke Hachinohe, MD, et al published long‐term follow‐up findings from a study of coronary covered stent implantation for various coronary artery diseases. The investigators evaluated the long‐term clinical outcomes after covered stent implantation and compared results according to the indications.
As summarized in CCI, this retrospective study enrolled 190 consecutive patients (212 lesions) implanted with a covered stent and surviving until discharge between May 1997 and February 2017. Clinical outcomes were evaluated and compared using the Gehan–Breslow–Wilcoxon test.
In the study patients, covered stents were mainly used for the treatment of a saphenous vein graft (SVG) (51.4%), followed by coronary artery perforation (CAP) (25%), and coronary artery aneurysm (CAA) (11.8%). The median follow‐up duration was 6 (interquartile range, 1.6–13.5) years.
The investigators found that target vessel myocardial infarction (MI), target vessel occlusion, target lesion revascularization, and stent thrombosis frequently occurred in the early follow‐up period (7.3%, 16.6%, 21.5%, and 8.9% at 1 year, respectively) and continued to increase throughout the long‐term follow‐up (14.8%, 38.6%, 38.7%, and 17.8% at 10 years, respectively).
Additionally, target vessel occlusion, target vessel MI, and stent thrombosis were not identified in CAA with superiority to CAP (Gehan–Breslow–Wilcoxon P‐value = .01, .047, and .046, respectively). SVG had a higher rate of target vessel occlusion than CAA (P = .004), reported the investigators in CCI.
The study investigators concluded that clinical events after covered stent implantation frequently occurred in the early period and steadily increased in the long‐term period. Also, covered stent implantation in CAA was associated with fewer adverse cardiac events and may lead to safe and acceptable outcomes. However, covered stents implanted in patients treated for CAP and SVG are associated with a high risk of long‐term cardiac events, advised the investigators in CCI.