Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents.
To evaluated prevalence and clinical implication of stent fracture and longitudinal compression in first- and new-generation drug-eluting stents (DES) using coronary computed tomography angiography (CCTA). The incidence of stent fracture and longitudinal compression were compared between first- and new-generation DES in 374 patients who underwent coronary stenting using DES and follow-up CCTA due to recurrent angina. 235 and 139 patients received 322 first- and 213 new-generation DES, respectively. The crude per-stent incidence of longitudinal compression (6.1 vs. 0.3 %, p < 0.001) was higher after new- than first-generation DES implantation using CCTA and the incidence of stent fracture (11.3 vs. 8.1 %, p = 0.23) was comparable. On follow-up coronary angiography for 347 stents, stent fracture (3.2 %) and longitudinal compression (0.9 %) were less detected than those on CCTA. Ostial stenting was a risk factor of longitudinal compression (p < 0.001). Stent fracture was associated with younger patients (p = 0.03), longer stent (p = 0.010), and excessively tortuous lesions (p = 0.001). The presence of stent fracture or longitudinal compression was not associated with poor clinical outcomes. The longitudinal compression more frequently occurred after new-generation DES implantation. The stent fracture was comparable between two DES. However, the occurrence of such mechanical deformities did not translate into a poor clinical outcome.
Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea.
Mi Sun
MS
Chung
Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea. donghyun.yang@gmail.com.
Dong Hyun
DH
Yang
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Young-Hak
YH
Kim
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Jae-Hyung
JH
Roh
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Jihyun
J
Song
Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea.
Joon-Won
JW
Kang
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Jung-Min
JM
Ahn
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Duk-Woo
DW
Park
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Soo-Jin
SJ
Kang
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Seung-Whan
SW
Lee
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Cheol Whan
CW
Lee
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Seong-Wook
SW
Park
Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Seung-Jung
SJ
Park
Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea.
Tae-Hwan
TH
Lim
D000368:Aged; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D012307:Risk Factors; D013314:Stress, Mechanical; D016896:Treatment Outcome
Compression; Drug-eluting stent; Fracture; Multidetector computed tomography; Stent