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Incidance, Treatment Options and Outcomes of Stent Loss During Percutaneous Coronary Intervention: A Single-Center Experience

Yıl 2020, Cilt: 10 Sayı: 4, 565 - 571, 15.12.2020
https://doi.org/10.31832/smj.747503

Öz

Objective: The aim of this study was to evaluate the demographic characteristics, incidence of stent loss, treatment methods and 30-day outcomes of the patients with stent loss during percutaneous coronary intervention (PCI).
Materials and Methods: Fifteen patients who lost a stent during PCI between December 2014 and February 2020 were included in the study. Outcomes were classified as myocardial infarction, requirement of bypass revascularization and mortality within 30 days.

Results: In our study, the incidence of stent loss during PCI was 0.15%. Of these patients, 12 (80%) were male. The mean age of the patients was 59.87 ± 8.67 years. In 3 patients, the stent was deployed at the same location, while in 4 patients, stent crush technique is used. The following retrieval methods were used: inflating the small balloon (%33.33) and snare (%20). One patient underwent coronary bypass surgery. One patient died in the hospital. Death, myocardial infarction andrequirement of bypass were not observed in the one-month follow-up in the remaining patients. Six patients had type C and 7 patients had type B2 lesions. Eight of the lesions were in left circumflex artery.
Conclusion: Coronary stent loss occurs more frequently in the left circumflex artery, and in type B2/C lesions in particular. Interventional cardiologists should know that different treatment methods are available for stent loss in lesions according to the location of the stent, and should be able to successfully treat stent loss in the light of the current data.

Kaynakça

  • 1. Iturbe JM, Abdel-Karim AR, Papayannis A, Mahmood A, Rangan BV, Banerjee S, et al. Frequency, treatment, and consequences of device loss and entrapment in contemporary percutaneous coronary interventions. J Invasive Cardiol 2012; 24:215-221.
  • 2. Alomar ME, Michael TT, Patel VG, Altomare CG, Rangan BV, Cipher D, et al. Stent loss and retrieval during percutaneous coronary interventions: a systematic review and meta-analysis. J Invasive Cardiol 2013; 25:637-41
  • 3. Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB 3rd, Loop FD, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988; 78:486–502.
  • 4. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al; ESC Scientific Document Group. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2019; 40:237–269.
  • 5. Brilakis ES, Best PJ, Elesber AA, Barsness GW, Lennon RJ, Holmes DR Jr, et al.Incidence, Retrieval Methods, and Outcomes of Stent Loss During Percutaneous Coronary Intervention: A Large Single-Center Experience. Catheter Cardiovasc Interv 2005; 66:333-40.
  • 6. Brilakis ES, Garratt KN. Device Loss during Percutaneous Coronary Intervention: Incidence, Complications, and Retrieval Methods. In: Ellis SG, Holmes DR Jr, editors. Strategic Approaches in Coronary Intervention. 3rd edition. Philadelphia, USA: Lippincott Williams and Wilkins 2005.p.434-3.
  • 7. Colkesen AY, Baltali M, Acil T, Tekin G, Tekin A, ErolT, et al. Coronary and systemic stent embolizationduring percutaneous coronary interventions: asingle center experience. Int Heart J 2007; 48:129-136.
  • 8. Bolte J, Neumann U, Pfafferott C, Vogt A, Engel HJ, Mehmel HC, et al.Incidence, management, and outcome of stent loss during intracoronary stenting. Am J Cardiol 2001; 88:565-7.
  • 9. Yurtdas M. Aladag N. Yaylali YT. Successful Transcatheter Retrieval of the Embolized Coronary Stent During Primary Percutaneous Coronary Intervention. J Med Cases 2016; 7:417-9.
  • 10. Singh V, Khare R, Chandra S, Dwivedi SK, Saran RK. Dislodgement of a sirolimus - eluting stent in the right coronary artery and its successful deployment with a small-balloon technique. J Indian Coll Cardiol 2014; 4:44-6.
  • 11. Schatz RA, Baim DS, Leon M, Ellis SG, Goldberg S, Hirshfeld JW, et al. Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study. Circulation 1991; 83:148-61.
  • 12. Saleh L, Movahed MR. Successful Conservative Treatment of an Undeployed Embolized Intracoronary Stent With Dual Antiplatelet and Warfarin Therapy. Exp Clin Cardiol 2010; 15:e70-2.
  • 13. Kammler J, Leisch F, Kerschner K, Kypta A, Steinwender C, Kratochwill H, et al. Long-term follow up in patients with lost coronary stents during interventional procedures. Am J Cardiol 2006; 98:367-9.
  • 14. Kocayigit I,Can Y, Yılmaz S, Kılıc H. Undeployed and uncrushed coronary stent in the proximal region of the normal left anterior descending artery revealed four years after intervention.Postepy Kardiol Interwencyjnej 2015; 11:256–257.
  • 15. Kobayashi Y, Nonogi H, Miyazaki S, Daikoku S, Yamamoto Y, Takamiya M. Successful retrieval of unexpanded Palmaz-Schatz stent from left main coronary artery. Cathet Cardiovasc Diagn 1996; 38:402-404.
  • 16. Senturk T, Ozdemir B, Yesilbursa D, Serdar OA. Dislodgement of a sirolimus-eluting stent in the circumflex artery and its successful deployment with a small-balloon technique. Turk Kardiyol Dern Ars 2011; 39:418-421.
  • 17. Yang DH, Woo SI, Kim DH, Park SD, Jang JH, Kwan J, et al. Two dislodged and crushed coronary stents: treatment of two simultaneously dislodged stents using crushing techniques. Korean J Intern Med 2013; 28:718–723.
  • 18. Wong PH. Retrieval of undeployed intracoronary Palmaz-Schatz stents. Cathet Cardiovasc Diagn 1995; 35:218-223.
  • 19. Kwan TW, Chaudhry M, Huang Y, Liou M, Wong S, Zhou X, et al. Approaches for dislodged stent retrieval during transradial percutaneous coronary interventions. Catheter Cardiovasc Interv 2013; 81:245-9.
  • 20. Douard H, Besse P, Broustet JP. Successful retrieval of a lost coronary stent from the descending aorta using a loop basket intravascular retriever set. Cathet Cardiovasc Diagn 1998; 44:224-226.
  • 21. Foster-Smith KW, Garratt KN, Higano ST, Holmes DR Jr. Retrieval techniques for managing flexible intracoronary stent misplacement. Cathet Cardiovasc Diagn 1993; 30:63-68.
  • 22. Khattab AA, Geist V, Toelg R, Richardt G. The AngioGuard: a simplified snare? Int J Cardiovasc Intervent 2004; 6:153-155.
  • 23. Brilakis ES, Abdel-Karim AR, Banerjee S. Hairpin-trap: a novel stent retrieval technique. Catheter Cardiovasc Interv 2011; 77:213-216.

Perkütan Koroner Girişim Sırasında Gelişen Stent Kaybının Sıklığı, Demografik Özelliklerinin ve Tedavilerinin Değerlendirilmesi: Tek Merkez Deneyimi

Yıl 2020, Cilt: 10 Sayı: 4, 565 - 571, 15.12.2020
https://doi.org/10.31832/smj.747503

Öz

Amaç: Bu çalışmanın amacı perkutan koroner girişim sırasında stent kaybı gelişen hastaların demografik özelliklerini, insidansını, tedavi yöntemlerini ve sonuçlarını değerlendirmektir.
Gereç ve Yöntemler: Aralık 2014 ve Şubat 2020 tarihleri arasında perkutan koroner girişim yapılması sırasında stent kaybı gelişen 15 hasta çalışmaya dahil edildi. Otuz gün içinde gözlenen miyokard infarktüsü, baypas ile revaskülarizasyon gereksinimi ve mortalite sonlanım noktaları olarak belirlendi.
Bulgular: Stent kaybı insidansı %0.15’dır. Çalışmaya dahil edilen hastaların ortalama yaşı 59.87 ± 8.67 olup hastaların 12’si (%80) erkek idi. Üç hastada stent aynı yere implante edilirken, 4 hastada ise farklı bir stent ile ezilerek damara yapıştırıldı. Beş hastada küçük balon ile 3 hastada ise kement ile koronerden geri alınmıştır. Bir hastaya koroner arter baypas operasyonu yapıldı. Bir hasta hastanede ex oldu. Geriye kalan hastalarda 30 günde ölüm, miyokard infarktüsü ve baypas ile revaskülarizasyon gereksinimi gözlenmedi. Altı hastada Tip C, 7 hastada ise Tip B2 lezyon gözlendi. Hastaların 8 tanesinde stent kaybı sirkumfleks arterdeydi.
Sonuç: Koroner stent kaybı tip B2/C lezyonlarının yanında özellikle sol sirkumfleks arterde daha sık meydana gelmektedir. Girişimsel kardiyologlar stent kaybı durumunda sıyrılan stentin bulunduğu yere göre farklı tedavi yöntemleri olduğunu bilmeli ve güncel veriler ışığında stent kayıplarını başarılı bir şekilde tedavi edebilmelidir.

Kaynakça

  • 1. Iturbe JM, Abdel-Karim AR, Papayannis A, Mahmood A, Rangan BV, Banerjee S, et al. Frequency, treatment, and consequences of device loss and entrapment in contemporary percutaneous coronary interventions. J Invasive Cardiol 2012; 24:215-221.
  • 2. Alomar ME, Michael TT, Patel VG, Altomare CG, Rangan BV, Cipher D, et al. Stent loss and retrieval during percutaneous coronary interventions: a systematic review and meta-analysis. J Invasive Cardiol 2013; 25:637-41
  • 3. Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB 3rd, Loop FD, et al. Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988; 78:486–502.
  • 4. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al; ESC Scientific Document Group. Fourth universal definition of myocardial infarction (2018). Eur Heart J 2019; 40:237–269.
  • 5. Brilakis ES, Best PJ, Elesber AA, Barsness GW, Lennon RJ, Holmes DR Jr, et al.Incidence, Retrieval Methods, and Outcomes of Stent Loss During Percutaneous Coronary Intervention: A Large Single-Center Experience. Catheter Cardiovasc Interv 2005; 66:333-40.
  • 6. Brilakis ES, Garratt KN. Device Loss during Percutaneous Coronary Intervention: Incidence, Complications, and Retrieval Methods. In: Ellis SG, Holmes DR Jr, editors. Strategic Approaches in Coronary Intervention. 3rd edition. Philadelphia, USA: Lippincott Williams and Wilkins 2005.p.434-3.
  • 7. Colkesen AY, Baltali M, Acil T, Tekin G, Tekin A, ErolT, et al. Coronary and systemic stent embolizationduring percutaneous coronary interventions: asingle center experience. Int Heart J 2007; 48:129-136.
  • 8. Bolte J, Neumann U, Pfafferott C, Vogt A, Engel HJ, Mehmel HC, et al.Incidence, management, and outcome of stent loss during intracoronary stenting. Am J Cardiol 2001; 88:565-7.
  • 9. Yurtdas M. Aladag N. Yaylali YT. Successful Transcatheter Retrieval of the Embolized Coronary Stent During Primary Percutaneous Coronary Intervention. J Med Cases 2016; 7:417-9.
  • 10. Singh V, Khare R, Chandra S, Dwivedi SK, Saran RK. Dislodgement of a sirolimus - eluting stent in the right coronary artery and its successful deployment with a small-balloon technique. J Indian Coll Cardiol 2014; 4:44-6.
  • 11. Schatz RA, Baim DS, Leon M, Ellis SG, Goldberg S, Hirshfeld JW, et al. Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study. Circulation 1991; 83:148-61.
  • 12. Saleh L, Movahed MR. Successful Conservative Treatment of an Undeployed Embolized Intracoronary Stent With Dual Antiplatelet and Warfarin Therapy. Exp Clin Cardiol 2010; 15:e70-2.
  • 13. Kammler J, Leisch F, Kerschner K, Kypta A, Steinwender C, Kratochwill H, et al. Long-term follow up in patients with lost coronary stents during interventional procedures. Am J Cardiol 2006; 98:367-9.
  • 14. Kocayigit I,Can Y, Yılmaz S, Kılıc H. Undeployed and uncrushed coronary stent in the proximal region of the normal left anterior descending artery revealed four years after intervention.Postepy Kardiol Interwencyjnej 2015; 11:256–257.
  • 15. Kobayashi Y, Nonogi H, Miyazaki S, Daikoku S, Yamamoto Y, Takamiya M. Successful retrieval of unexpanded Palmaz-Schatz stent from left main coronary artery. Cathet Cardiovasc Diagn 1996; 38:402-404.
  • 16. Senturk T, Ozdemir B, Yesilbursa D, Serdar OA. Dislodgement of a sirolimus-eluting stent in the circumflex artery and its successful deployment with a small-balloon technique. Turk Kardiyol Dern Ars 2011; 39:418-421.
  • 17. Yang DH, Woo SI, Kim DH, Park SD, Jang JH, Kwan J, et al. Two dislodged and crushed coronary stents: treatment of two simultaneously dislodged stents using crushing techniques. Korean J Intern Med 2013; 28:718–723.
  • 18. Wong PH. Retrieval of undeployed intracoronary Palmaz-Schatz stents. Cathet Cardiovasc Diagn 1995; 35:218-223.
  • 19. Kwan TW, Chaudhry M, Huang Y, Liou M, Wong S, Zhou X, et al. Approaches for dislodged stent retrieval during transradial percutaneous coronary interventions. Catheter Cardiovasc Interv 2013; 81:245-9.
  • 20. Douard H, Besse P, Broustet JP. Successful retrieval of a lost coronary stent from the descending aorta using a loop basket intravascular retriever set. Cathet Cardiovasc Diagn 1998; 44:224-226.
  • 21. Foster-Smith KW, Garratt KN, Higano ST, Holmes DR Jr. Retrieval techniques for managing flexible intracoronary stent misplacement. Cathet Cardiovasc Diagn 1993; 30:63-68.
  • 22. Khattab AA, Geist V, Toelg R, Richardt G. The AngioGuard: a simplified snare? Int J Cardiovasc Intervent 2004; 6:153-155.
  • 23. Brilakis ES, Abdel-Karim AR, Banerjee S. Hairpin-trap: a novel stent retrieval technique. Catheter Cardiovasc Interv 2011; 77:213-216.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Yusuf Can 0000-0002-4535-7367

İbrahim Kocayiğit 0000-0001-8295-9837

Muhammed Aksoy 0000-0002-7722-0330

Yayımlanma Tarihi 15 Aralık 2020
Gönderilme Tarihi 3 Haziran 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 10 Sayı: 4

Kaynak Göster

AMA Can Y, Kocayiğit İ, Aksoy M. Perkütan Koroner Girişim Sırasında Gelişen Stent Kaybının Sıklığı, Demografik Özelliklerinin ve Tedavilerinin Değerlendirilmesi: Tek Merkez Deneyimi. Sakarya Tıp Dergisi. Aralık 2020;10(4):565-571. doi:10.31832/smj.747503

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