High frequency of brachiocephalic trunk stent fractures does not impair clinical outcome.
OBJECTIVE
Stenting is the preferred, minimally invasive treatment for innominate artery (IA) stenosis or occlusion. Stent fractures in the IA have not been assessed in larger cohorts. In this retrospective study, we examined the frequency and risk factors of IA stent fractures.


METHODS
The final analysis included 32 patients (15 women; mean age, 59.4 ± 12.0 years) with 32 balloon-expandable stents (2000 to 2009). In 2010, the patients were asked to come back for a fluoroscopic examination of the implanted stents. Stent fractures and their relationship to atherosclerotic risk factors, lesion characteristics, postprocedural symptoms, and in-stent restenosis were analyzed. Fisher exact test and univariate Cox regression analysis were used in the statistical evaluation.


RESULTS
Lesions were >20 mm in 14 patients (44%) or heavily calcified in 13 (41%). The mean follow-up time was 33.4 ± 21.0 months. Postprocedural symptoms were noted in nine patients (28%). Significant restenosis was detected in 22% of the implanted stents, and 11 stent fractures (34%) were found. The prevalence of heavily calcified lesions, postprocedural symptoms, and in-stent restenosis did not differ significantly between groups with and without fracture. Long lesions were associated with an increased incidence of stent fracture (hazard ratio, 5.09; 95% confidence interval, 1.33-19.48; P = .017). No correlation was observed between stent fractures and old age (≥70 years), female gender, smoking, hypertension, hyperlipidemia, or diabetes mellitus.


CONCLUSIONS
IA stent fractures are common but seem to have no effect on symptoms and in-stent restenosis rates.
Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address: dosaedit@yahoo.com.
Edit
E
Dósa
Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Balázs
B
Nemes
Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary.
Viktor
V
Bérczi
Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary.
Pál Kaposi
PK
Novák
Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Tamás Mirko
TM
Paukovits
Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Hunor
H
Sarkadi
Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
Kálmán
K
Hüttl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000628:therapy*; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011475:Prosthesis Failure; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000628:therapy