title: Predictors of stent fracture in patients treated with closed-cell design stents: sirolimus-eluting stent and its bare-metal counterpart, the BX velocity stent.
abstract: OBJECTIVE
  The aim of this study was to evaluate the predictors of coronary stent fracture in patients treated with closed-cell design stents including the sirolimus-eluting stent (SES) and its bare-metal platform, Bx velocity stent (BVS).
  
  
  BACKGROUND
  Various mechanical factors have been considered to be the predictors of stent fracture, especially in patients treated with SES. However, it is unknown whether SES is more prone to fracture compared with BVS.
  
  
  METHODS
  We retrospectively analyzed 391 lesions treated with SES or BVS in 339 patients who underwent follow-up coronary angiography.
  
  
  RESULTS
  A total of 30 stent fractures (7.7%) in 28 patients treated with 29 SES (96.7%) and one BVS (3.3%) was found. On univariate analyses, stent fracture was related to angulated lesions (>45°) during diastole, longer stent, larger number of stents per lesion (P<0.001), right coronary artery (RCA) placement (P=0.008), and SES (P=0.016). On multivariate analyses, however, angulated lesion (odds ratio: 6.73; 95% confidence interval: 2.71-16.71; P<0.001) and RCA placement (odds ratio: 2.82; 95% confidence interval: 1.03-7.72; P=0.044) served as independent predictors of stent fracture while SES (P=0.080) and total stent length (P=0.069) showed only trends that did not reach statistical significance.
  
  
  CONCLUSIONS
  This study showed that fracture of SES or BVS with the same closed-cell design platform was related to angulated lesion and RCA placement, but SES itself was not an independent predictor of stent fracture.
authors.affiliation: Heart Center, Sung Ae Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Park
authors.forename: Jong-Youn
authors.initials: JY
authors.lastname: Kim
authors.forename: Bum-Kee
authors.initials: BK
authors.lastname: Hong
authors.forename: Byoung Kwon
authors.initials: BK
authors.lastname: Lee
authors.forename: Pil-Ki
authors.initials: PK
authors.lastname: Min
authors.forename: Sejoong
authors.initials: S
authors.lastname: Rim
authors.forename: Hee-Sun
authors.initials: HS
authors.lastname: Mun
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Kwon
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Park
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D057186:Comparative Effectiveness Research; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000592:standards; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis / Q000503:physiopathology*; D012307:Risk Factors; D020123:Sirolimus / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus