title: Prospective Identification of Stent Fracture by Enhanced Stent Visualization System During Percutaneous Coronary Intervention.
abstract: No study has evaluated the clinical consequences of stent fracture (SF) detected during the index percutaneous coronary intervention (PCI). Thus, we sought to investigate the relationship between SF detected during PCI and clinical outcome.
  
  
  
  We consecutively enrolled 832 patients with SF-predisposing factors undergoing 2nd-generation drug-eluting stent implantation and enhanced stent visualization (ESV) system evaluation to detect SF at index PCI. The primary endpoint was a 9-month device-oriented endpoint (DOCE, including cardiac death, target vessel myocardial infarction, and target lesion revascularization). We observed 136 SF in 115 patients (14% of study population). SF I-II was present in 78 patients (68% of patients with SF), and SF III-IV occurred in 37 patients (32%). DOCE at 9 months occurred in 135 patients (16% of the overall population). There was a significant difference in DOCE occurrence between the 3 groups (P=0.006 at log-rank), driven by the SF III-IV group (P=0.001 vs. no SF group, and P=0.01 vs. SF I-II group). In 23 cases of SF III-IV (62%) a further stent was implanted. DOCE occurrence was significantly higher in patients with "untreated" type III-IV SF as compared with the "treated" ones (9% vs. 79%, P<0.01).
  
  
  
  The ESV system is helpful in detecting SF during the index PCI. Type III-IV SFs are associated with a higher incidence of DOCE.
authors.affiliation: Cardiovascular Institute, Medical Sciences Department, Azienda Ospedaliero-Universitaria S.Anna.
authors.forename: Simone
authors.initials: S
authors.lastname: Biscaglia
authors.forename: Matteo
authors.initials: M
authors.lastname: Tebaldi
authors.forename: Carlo
authors.initials: C
authors.lastname: Tumscitz
authors.forename: Rita
authors.initials: R
authors.lastname: Pavasini
authors.forename: Jlenia
authors.initials: J
authors.lastname: Marchesini
authors.forename: Francesco
authors.initials: F
authors.lastname: Gallo
authors.forename: Giosafat
authors.initials: G
authors.lastname: Spitaleri
authors.forename: Fatima
authors.initials: F
authors.lastname: Zaraket
authors.forename: Matteo
authors.initials: M
authors.lastname: Serenelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Cimaglia
authors.forename: Giulia
authors.initials: G
authors.lastname: Bugani
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D011475:Prosthesis Failure / Q000009:adverse effects*