title: Clinical outcomes and optimal treatment for stent fracture after drug-eluting stent implantation.
abstract: BACKGROUND
  Many studies have suggested that in the era of drug-eluting stents (DES) one of the causes of in-stent restenosis is stent fracture (SF). Yet there have been few studies of the major adverse cardiac events and treatment of DES SF.
  
  
  RESULTS
  From September 2003 to May 2008, 3365 patients received successful stent implantation with DES, of whom 1009 patients underwent a follow-up coronary angiography irrespective of symptoms. Seventeen SFs were detected in 15/1009 patients (1.5%). All SF patients were continued on medication with combination antiplatelet therapy, regardless of angina symptoms. If in-stent restenosis at the fractured site was significant, we performed coronary interventions even in patients without ischemic symptoms. Patients were treated with heterogenous DES for restenosis lesions (5/8 patients), and the rest were treated with either homogenous DES (2 patients), or plain old balloon angioplasty (1 patient) or medical treatment (7 patients). None of the SF patients suffered from cardiac death during a follow-up period of 20.4+/-12.3 months.
  
  
  CONCLUSIONS
  If patients with SF were continued on combination antiplatelet therapy irrespective of ischemic symptoms, there would occur a low rate of major adverse cardiac events, especially cardiac death associated with SF.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Dong Ku, Gwangju, South Korea.
authors.forename: Shin Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: In Soo
authors.initials: IS
authors.lastname: Kim
authors.forename: Jum Suk
authors.initials: JS
authors.lastname: Ko
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Won Yu
authors.initials: WY
authors.lastname: Kang
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011379:Prognosis; D011475:Prosthesis Failure; D012189:Retrospective Studies
chemical_list: D010975:Platelet Aggregation Inhibitors