title: Incidence, predictive factors, and clinical impact of stent recoil in stent fracture lesion after drug-eluting stent implantation.
abstract: BACKGROUND
  Stent fracture (SF) after drug-eluting stent (DES) implantation was reported to be associated with target lesion revascularization (TLR). We have noted abnormal late acquired stent axial deformation in lesions after DES implantation, especially in SF lesions, and defined it as stent recoil (SR). We evaluated the incidence, predictive factors, and clinical impact of SR in SF lesions.
  
  
  METHODS
  Between 2003 and 2012, 5456 patients (11,712 lesions) underwent DES implantations and follow-up angiography within one year after the index procedure. SR was defined as an axial recoil deformation less than 80% of the stent diameter and SF was defined as the separation of stent segments or stent struts. SF and SR were confirmed by follow-up angiography. The primary endpoint was defined as clinically driven TLR.
  
  
  RESULTS
  SF was observed in 494 lesions (4.2%) and SR in 138 of SF lesions (27.9%). According to multinomial logistic regression analyses, severe calcification and ostial lesion in the right coronary artery were stronger predictive factors of SF with SR lesions. The cumulative incidences of any and clinically driven TLR at 5years were both significantly higher in the SF with SR group than in the SF without SR group (51.7% versus 35.0%, P<0.001; 22.2% versus 12.8%, P=0.019; respectively).
  
  
  CONCLUSIONS
  SR in SF lesions after DES implantation could be related to the lesion characteristics. SF with SR was highly associated with subsequent TLR compared with SF without SR.
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Ohya
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.. Electronic address: k-kadota@lapis.plala.or.jp.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kubo
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Habara
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Takenobu
authors.initials: T
authors.lastname: Shimada
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Hidewo
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Izawa
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hyodo
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Otsuru
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Daiji
authors.initials: D
authors.lastname: Hasegawa
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fuku
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Goto
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data*; D011475:Prosthesis Failure; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D061205:Vascular Calcification
keywords: Drug-eluting stent; Percutaneous coronary intervention; Stent deformation; Stent fracture