{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:15:07Z","timestamp":1784758507707,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,10,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The objective of the GNOCCI (Glasgow Natural History Study of Covered Stent Coronary Interventions) Study was to report the incidence and outcomes of coronary artery perforations over an 18\u2010year period at a single, high\u2010volume percutaneous coronary intervention center. We considered both the temporal trends and long\u2010term outcomes of covered stent deployment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We evaluated procedural and long\u2010term clinical outcomes following coronary perforation in a cohort of 43,343 consecutive percutaneous coronary intervention procedures. Procedural major adverse cardiac events were defined as a composite of death, myocardial infarction, stroke, target vessel revascularization, or cardiac surgery within 24\u00a0hours. A total of 161 (0.37%) procedures were complicated by coronary perforation of which 57 (35%) were Ellis grade III. Incidence increased with time over the study period (\n              <jats:italic>r<\/jats:italic>\n              =0.73;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Perforation severity was linearly associated with procedural mortality (median 2.9\u2010year follow\u2010up): Ellis I (0%), Ellis II (1.7%), Ellis III\/IIIB (21%),\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001. Procedural major adverse cardiac events occurred in 47% of patients with Ellis III\/IIIB versus 13.5% of those with Ellis I\/II perforations (odds ratio, 5.8; 95% CI, 2.7\u201312.5;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Covered stents were associated with an increased risk of stent thrombosis at 2.9\u2010year follow\u2010up (Academic Research Consortium definite or probable; 9.1% versus 0.9%; risk ratio, 10.5; 95% CI, 1.1\u201397;\n              <jats:italic>P<\/jats:italic>\n              =0.04).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The incidence of coronary perforation increased between 2001 and 2019. Severe perforation was associated with higher procedural major adverse cardiac events and was an independent predictor of long\u2010term mortality. Although covered stents are a potentially lifesaving treatment, the generation of devices used during the study period was limited by their efficacy and high risk of stent thrombosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration Information<\/jats:title>\n            <jats:p xml:lang=\"en\">Clinicaltrials.gov. Identifier: NCT03862352.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024492","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T10:37:57Z","timestamp":1663756677000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Coronary Artery Perforations: Glasgow Natural History Study of Covered Stent Coronary Interventions (GNOCCI) Study"],"prefix":"10.1161","volume":"11","author":[{"given":"Thomas J.","family":"Ford","sequence":"first","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"},{"name":"Faculty of Medicine University of Newcastle Callaghan NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7019-7329","authenticated-orcid":false,"given":"Carly","family":"Adamson","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4067-8249","authenticated-orcid":false,"given":"Andrew J.","family":"Morrow","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow 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Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aadil","family":"Shaukat","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Lindsay","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Good","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1579-6294","authenticated-orcid":false,"given":"Stuart","family":"Watkins","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Eteiba","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Robertson","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4547-8636","authenticated-orcid":false,"given":"Colin","family":"Berry","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith G.","family":"Oldroyd","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5135-3322","authenticated-orcid":false,"given":"Margaret","family":"McEntegart","sequence":"additional","affiliation":[{"name":"West of Scotland Heart and Lung Centre Golden Jubilee National Hospital Clydebank UK"},{"name":"British Heart Foundation Glasgow Cardiovascular Research CentreInstitute of Cardiovascular and Medical SciencesUniversity of Glasgow Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"680","key":"e_1_3_2_2_2","first-page":"A8","article-title":"Incidence, management, and outcome of coronary artery perforation during percutaneous coronary intervention","volume":"86","author":"Gruberg L","year":"2000","unstructured":"Gruberg L, Pinnow E, Flood R, Bonnet Y, Tebeica M, Waksman R, Satler LF, Pichard AD, Kent KM, Leon MB, et al. 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