Contemporary Use of Coils During Percutaneous Coronary Intervention: Insights From the Multicenter COILSEAL Registry

BACKGROUND: Use of coils during percutaneous coronary interventions (PCI) is often life-saving and useful, although their off-label use according to the instructions for use. AIMS: Evaluation of in-hospital and long-term outcomes of patients undergoing PCI with coil implantation for treating coronary perforation or closing coronary artery aneurysms/fistulas. METHODS: Among 245,652 PCIs performed in 17 high-volume European centers, 143 patients (0.06%) undergoing coil implantation during PCI were finally included in the analysis. PCI strategy (coiling performed during coronary perforation vs. closing aneurysm/fistulas) and procedural devices used were collected. The primary outcome was technical success, defined as the successful sealing of coronary perforation or aneurysm/fistulas, and procedural success defined as technical success without in-hospital major cardiovascular events (MACE). Long-term MACE and mortality were also reported. RESULTS: The primary outcome occurred in 95.7% of cases, with no significant differences observed between the perforation and aneurysm/fistulas groups (94.5% vs. 100%, p = 0.19). Patients in the perforation group had a significantly lower rate of procedural success (83.5% vs. 96.6%, p = 0.01). Target lesion failure occurred in 11.4% of cases without differences between groups at a median follow-up of 2 years. CONCLUSIONS: Coils implantation during PCI is safe and feasible among patients treated for coronary perforations or closing aneurysms/fistulas.