Rapid sealing of coronary perforations using polytetrafluoroethylene-covered stents

Coronary artery perforation is a life-threatening complication of percutaneous interventional procedures.' Angiographic evidence for perforation has been reported in 0.1% of patients treated with percutaneous transluminal coronary angioplasty alone. The incidence of this complication increases to 0.5% to 3.0% in treating more complex lesion subsets with more aggressive interventional techniques, including rotational atherectomy, directional coronary atherectomy, and excimer laser coronary angioplasty. Surgical intervention has been required in a high proportion of cases because of persistent coronary leak or ongoing ischemia. The premounted polytetrafluoroethylene (PTFE)-covered stent offers the potential for rapid percutaneous sealing of coronary perforations and offers a realistic alternative to high-risk emergency coronary surgery. We outline our experience using this new device to treat this potentially catastrophic complication of percutaneous intervention.