Incidence and clinical impact of stent fracture after everolimus-eluting stent implantation

Shoichi Kuramitsu, Masashi Iwabuchi, Takuya Haraguchi, Takenori Domei, Ayumu Nagae, Makoto Hyodo, Kyohei Yamaji, Yoshimitsu Soga, Takeshi Arita, Shinichi Shirai, Katsuhiro Kondo, Kenji Ando, Koyu Sakai, Masahiko Goya, Yoshitaka Takabatake, Shinjo Sonoda, Hiroyoshi Yokoi, Fumitoshi Toyota, Hideyuki Nosaka, Masakiyo Nobuyoshi

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Abstract

Background: Stent fracture (SF) after drug-eluting stent implantation has recently become an important concern because of its potential association with in-stent restenosis and stent thrombosis. However, the incidence and clinical impact of SF after everolimus-eluting stent implantation remain unclear. Methods and Results: A total of 1035 patients with 1339 lesions undergoing everolimus-eluting stent implantation and follow-up angiography 6 to 9 months after index procedure were analyzed. SF was defined as complete or partial separation of the stent, as assessed by plain fuoroscopy or intravascular ultrasound during follow-up. We assessed the rates of SF and major adverse cardiac events, defined as cardiac death, myocardial infarction, stent thrombosis, and clinically driven target lesion revascularization within 9 months. SF was observed in 39 of 1339 lesions (2.9%) and in 39 of 1035 patients (3.8%). Ostial stent location and lesions with hinge motion, tortuosity, or calcification were independent predictors of SF. The rate of myocardial infarction and target lesion revascularization were significantly higher in the SF group than in the non-SF group (5.1% versus 0.4%; P=0.018 and 25.6% versus 2.0%; P<0.001, respectively). Stent thrombosis was more frequently observed in the SF group than in the non-SF group (5.1% versus 0.4%; P=0.018). Major adverse cardiac events within 9 months were significantly higher in the SF group than in the non-SF group (25.6% versus 2.3%; P<0.001). Conclusions: SF after everolimus-eluting stent implantation occurs in 2.9% of lesions and is associated with higher rate of major adverse cardiac events, driven by higher target lesion revascularization and stent thrombosis.

Original languageEnglish
Pages (from-to)663-671
Number of pages9
JournalCirculation: Cardiovascular Interventions
Volume5
Issue number5
DOIs
Publication statusPublished - Oct 1 2012

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Kuramitsu, S., Iwabuchi, M., Haraguchi, T., Domei, T., Nagae, A., Hyodo, M., Yamaji, K., Soga, Y., Arita, T., Shirai, S., Kondo, K., Ando, K., Sakai, K., Goya, M., Takabatake, Y., Sonoda, S., Yokoi, H., Toyota, F., Nosaka, H., & Nobuyoshi, M. (2012). Incidence and clinical impact of stent fracture after everolimus-eluting stent implantation. Circulation: Cardiovascular Interventions, 5(5), 663-671. https://doi.org/10.1161/CIRCINTERVENTIONS.112.969238