Predictors and prognosis of stent fracture after sirolimus-eluting stent implantation.
BACKGROUND
Stent fracture is a cause of in-stent restenosis (ISR) after sirolimus-eluting stent (SES) implantation, so this study investigated the incidence, predictors and prognosis of stent fracture.


RESULTS
The 273 consecutive patients (364 lesions) after SES implantation and who had 6-9 month' scheduled follow-up coronary angiography (CAG) were divided into groups with and without stent fracture. Deltaangle was defined as the difference in the angle in the target lesion between diastole and systole before the procedure. The incidence of stent fracture was 4.9% (18 of 364 lesions). Deltaangle in the target lesion was larger in the fracture group (28.3 +/-11.5 degrees vs 12.3 +/-9.0 degrees , P<0.0001). Independent predictors of stent fracture were Deltaangle and total stent length. The rates of binary restenosis and target lesion revascularization (TLR) were higher in the fracture group (33% vs 4.0%, P=0.0002 and 28% vs 3.5%, P=0.0007, respectively). There were no major adverse cardiac events (MACE) in the fracture group during a mean 24-month follow-up after follow-up CAG.


CONCLUSIONS
Predictors of stent fracture were Deltaangle and total stent length. Although stent fracture was associated with ISR and TLR, it was not associated with MACE during long-term follow-up.
Ino
Yasushi
Y
Division of Cardiology, Wakayama National Hospital, Wakayama, Japan.
Toyoda
Yasuaki
Y
Tanaka
Atsushi
A
Ishii
Shuuta
S
Kusuyama
Yoshio
Y
Kubo
Takashi
T
Takarada
Shigeho
S
Kitabata
Hironori
H
Tanimoto
Takashi
T
Mizukoshi
Masato
M
Imanishi
Toshio
T
Akasaka
Takashi
T
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology; D054855:Drug-Eluting Stents; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009038:Motion; D011379:Prognosis; D011475:Prosthesis Failure; D020123:Sirolimus / Q000008:administration & dosage*
D007166:Immunosuppressive Agents; D020123:Sirolimus