title: Restenosis and stent fracture following sirolimus-eluting stent (SES) implantation.
abstract: BACKGROUND
  Restenosis still occurs, even with the sirolimus-eluting stent (SES), and the precise mechanisms and the impact of stent fracture on restensosis have not yet been elucidated.
  
  
  RESULTS
  Intravascular ultrasound (IVUS)-guided SES implantation was performed in 184 lesions in 151 patients with stable and unstable angina. Serial (pre-, post- and follow-up) quantitative coronary angiography analysis was obtained in 169 lesions in 138 patients (angiographic follow-up rate: 91%) and 12-month clinical follow-up was done in all patients. Restenosis occurred in 13 (7.7%) of 169 lesions. Stent fracture occurred in 4 (2.4%) of 169 lesions at follow-up. Of the 13 restenotic lesions, 8 had intimal hyperplasia, 4 had stent fracture, and 1 had late stent thrombosis at 7 months. Although multivariate logistic regression analysis revealed that minimal lumen area (min-LA) post (p=0.027), total stent length (p=0.003) and diabetes (p=0.032) were significant independent predictors of restenosis, univariate analysis showed that stent fracture was more common in the restenosis than in the non-restenosis groups (p=0.001).
  
  
  CONCLUSIONS
  Although min-LA post by IVUS, total stent length by QCA and diabetes are independent predictors for angiographic restenosis, stent fracture occurred in 4 lesions (2.4%) and all of them resulted in restenosis (31% of the restenosis). The impact of stent fracture and its potential role in the development of restenosis deserves further study.
authors.affiliation: Division of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Okumura
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Junichi
authors.initials: J
authors.lastname: Ishii
authors.forename: Shino
authors.initials: S
authors.lastname: Kan
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Naruse
authors.forename: Shigeru
authors.initials: S
authors.lastname: Matsui
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Kousuke
authors.initials: K
authors.lastname: Hattori
authors.forename: Tomoko
authors.initials: T
authors.lastname: Gochi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kato
authors.forename: Sadako
authors.initials: S
authors.lastname: Motoyama
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Sarai
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Tevfik F
authors.initials: TF
authors.lastname: Ismail
authors.forename: Masanori
authors.initials: M
authors.lastname: Nomura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
mesh_terms: D000368:Aged; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D003328:Coronary Thrombosis / Q000150:complications; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000150:complications / Q000473:pathology; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional