The incidence and clinical impact of stent strut fractures developed after drug-eluting stent implantation.
BACKGROUND
Cases of stent strut fractures (SSFs) after DES implantation have been reported, but the clinical significance is uncertain. Then we sought to define the incidence and clinical implications of SSFs developed after drug-eluting stent (DES) implantation.


METHODS
We gathered SSF cases from 13 centers in Korea retrospectively. SSF was defined as angiographically visible interrupted connection of stent struts or fewer visible stent struts at the suspected site than normally looking stented area on intravascular ultrasound (IVUS). Furthermore, we classified the SSFs cases into three patterns (disruption, avulsion, and displacement) according to the interruption site and absence or presence of displacement.


RESULTS
Thirty-seven SSFs (2 disruption, 7 avulsion, 28 displacement) were detected in 35 lesions in 35 patients. All fractured stents were sirolimus-eluting stents (SESs). The incidence of SSFs was 0.84% and the proportion of restenosis related with SSF was 6.3% after SES implantation driven from the data of 8 centers. The average length of stent used was 49 mm, overlapping stenting was performed in 19 lesions (54%), and the average maximal angulation in the initial coronary angiography was 67 degrees . Twenty-four fractures (65%) were associated with focal in stent restenosis and 11 fractures (30%) with target lesion revascularization. No acute coronary syndrome developed.


CONCLUSIONS
SSF after DES implantation might be a considerable complication after DES implantation especially after SES implantation.
Chung
Wook-Sung
WS
Catholic University Saint Mary's Hospital, Youeuido-dong, Youngdeungpo-gu, Seoul, 150-713 Korea.
Park
Chul-Soo
CS
Seung
Ki-Bae
KB
Kim
Pum-Joon
PJ
Lee
Jong-Min
JM
Koo
Bon-Kwon
BK
Jang
Yang-Soo
YS
Yang
Joo-Young
JY
Yoon
Jung-Han
JH
Kim
Doo-Il
DI
Yoon
Young-Won
YW
Park
Jong-Seon
JS
Cho
Yoon-Haeng
YH
Park
Seung-Jung
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage
D007166:Immunosuppressive Agents; D020123:Sirolimus